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XXIX] In this place I shall discuss briefly (1) bacillary dysentery; (2) amœbic dysentery; (3) balantidium dysentery. Reference to the other forms will be found under their respective parasites.

The characteristics of this type of dysentery, at all events of that type of bacillary dysentery which has received of late so much attention, are acuteness of onset, often a well-marked initial fever, little tendency to relapse after the initial attack, the presence of Bacillus dysenteriœ in the stools, an initial diphtheroid necrosis of the mucosa of the large intestine, non-liability to abscess of the liver, occurrence in epidemic form and in all latitudes, and in the lunatic asylums of this and other countries.

Celli and Fiocca believed that dysentery is caused by Bacterium coli commune, which, they asserted, is always present in the stools in this disease. Generally non-pathogenic, this bacterium, they stated, acquires in certain circumstances virulent properties. They said that in the bowel it is often associated with a bacillus like that of typhoid, as well as with streptococci; and they asserted that introduced by the mouth, or injected by the rectum, any or all of these, particularly when in combination and in certain not understood circumstances, either singly or in combination, excite dysentery. They supposed that what they call Bacterium coli dysenteriœ is but a variety of Bacterium coli commune, a variety brought about in some way by the presence of the other bacteria mentioned; that in consequence of the presence of these other bacteria Bacterium coli commune acquires the power of secreting a specific toxin, which power it retains on being transferred from one human being to another. The toxin can be precipitated by alcohol from cultures, and has the property of giving rise to dysentery when ad ministered by the mouth, the anus, or hypodermically. Shiga was the first to call marked attention to what is now known as Bacillus dysenteriœ, which Celli regards as identical with the organism just alluded