On the pathology and treatment of dysentery : being the Gulstonian lectures delivered at the College of Physicians, in February 1847 / by William Baly.
- Date:
- [1847]
Licence: Public Domain Mark
Credit: On the pathology and treatment of dysentery : being the Gulstonian lectures delivered at the College of Physicians, in February 1847 / by William Baly. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![The poison of dysentery and that of typhoid differ much in their action on the human body. The poison of fever has an especial affinity for the glands of the small intestines, and also produces almost imme- diately an evident change in the constitution of the blood. The poison of dysentery attacks the glands of the large intestines, and in the more common sthenic form of the disease produces no obvious change in the condition of the circulating fluid. There is, however, as we have before seen, an asthenic variety of dysentery in which the blood does apparently undergo a change in its composition and vital properties; and here we must suppose that the poison of dysentery is modified in its properties, or that it is combined with some other noxious matter capable of disturbing the normal con- stitution of the blood. It remains to inquire what cause or causes produced those nervous disorders which at different periods have appeared amongst the prisoners in the Millbank Penitentiary. How has it happened that disorders of this kind have shown themselves prominently in connection with dysentery only in that esta- blishment ? The first important fact to be noticed in relation to this inquiry is, that these ner- vous disorders have not been constantly prevalent in the institution. They have appeared only at those times when dysentery was epidemic in the prison, or was about to become so. This fact suggests the inference that some alliance exists between the cause of the dysentery and the influence giving rise to these nervous disorders : an inference which is strengthened by another important fact, viz. that tetanus and neuralgia have been observed as endemic diseases in mala- rious countries. With respect to tetanus, no doubt exists but that it is far more common among adults in hot climates than in tein])erate ones, and in hot seasons than in those that are cool; while the tetanus or trismus of infants is seen chiefly in pestilential coun- tries, such as the West Indies, and in tem- perate climates only under circumstances which favour the belief that it is produced by a noxious state of the atmosphere. Now it has been observed that the adults attacked by idiopathic tetanus in hot climates are for the most part persons who have suflered hardships, or have been more tiian usually exposed to the deleterious influence of the climate. The infants we may-suppose to have been predisposed to suffer from the disease by the delicacy of their whole con- stitution, and especially by the excitability of their nervous system. Will not these tacts help us to explain the occurrence of peculiar nervous disor- ders in the prisoners at Millbank ? Besides confirming the opinion that the efficient cause of these disorders is some kind of malaria, do not these facts also render it probable that a peculiar state of the system of the prisoners has predisposed them to be thus jieculiarly affected by a cause which would have produced no such symptoms in other persons ? We have already seen that the effects of imprisonment on the nutritive system are such that severe inflammation and change of structure is produced in the prisoners by a morbific influence which does not affect free persons who are equally or almost equally exposed to it. May not imprisonment so affect the nervous system, likewise, as to give it an extreme excitability comparable to that which predisposes infants to suffer from trismus under the influence of ma- laria If we consider for a moment the effect which long-continued exclusion of light has on the eye, the great sensibility of that organ which results, so that it cannot bear ordinarj;^daylight, suddenly restored, without pain, or sunlight without danger, we shall, I think, find it reasonable to expect that the whole nervous system of prisoners who have been very long confined in complete or almost complete seclusion from society and from all the ordinary sources of mental ex- citement will manifest an exaggerated sensi- bility to the influence of unusual stimulants. At all events, facts have occurred during the last few years which prove the existence of this sensitive state of the nervous system in prisoners under such circumstances. Prisoners sentenced to transportation after being confined for a longer or shorter time in Government prisons in a state of the greatest order and silence, deprived of the society of their fellows and of all the causes of excitement to which they had been accustomed, have been suddenly transferred to convict ships in the river, where they have been thrown together without disci- pline or restraint of any kind, and exposed to the additional excitement of the parting with friends, and to the tumult which must exist in ships preparing for sea. The eflect of this sudden change has been that many of the prisoners have been thrown into fits of epile|)tic convulsions : not merely men and women previously subject to epilepsy, but those who had never before suflered from the disease, have been so affected. This has occurred, not once only, but several times, many prisoners being attacked with epilepsy in each ship. It is only during the first few days after embarkation that these sj mptoms ol disor- dered nervous system have been observed ; and no serious consequences have been left. But although so temporary, these pheno- mena are important from their proving that](https://iiif.wellcomecollection.org/image/b21955578_0033.jp2/full/800%2C/0/default.jpg)
