Definition. Causes: As in ordinary enteritis, with added infections or
toxins. Symptoms: As in enteritis, nervous symptoms, diarrhœa.
Lesions: Congested mucosa, whitish or grayish false membranes, in
patches or tubular casts, granular, mucous, albuminoid, fibrinous.
Diagnosis: False membranes in stools. Treatment: Glauber salts,
calomel, alkaline carbonates or tartrates, oils, antiferments,
demulcents, careful diet, bitters.
_Definition._ An inflammatory affection of the bowels characterized by
the ejection with the fæces of false membranes.
_Causes._ It has been long attributed to the causes which produce other
forms of enteritis and indigestions, as youth, rich stimulating feeding,
sudden change to green food in spring, sudden chills, over-fatigue,
confinement indoors, and prolonged costiveness. In man it is found as a
sequel of infectious diseases (pneumonia, pyæmia), in Bright’s disease,
cirrhosis of the liver and cancer, and in poisoning by lead, mercury or
arsenic (Osler). Cadeac, who found great numbers of streptococci in the
false membranes in animals, is certain it is a microbian disease, and
this is doubtless true, if qualified by the statement that the microbe
as is so often the case with other intestinal affections, requires an
occasion in the form of a diseased or debilitated condition of the
mucosa to enable it to become pathogenic. The disease is not known to
propagate itself indefinitely or without such a predisposing occasion.
_Symptoms._ There are dullness, prostration, langor, hyperthermia,
accelerated pulse, and colics which may be slight or very severe. In
some cases nervous symptoms have been observed, such as irritability or
stupor and somnolence with icterus and fœtid stools. The fæces are
usually semi-liquid, implying an excessive liquid secretion as well as
the exudation of the membranous matter.
_Lesions._ There is a pink congestion of the intestinal mucosa more or
less generally distributed. Whitish false membranes cover patches
chiefly on the terminal portion of the small intestine, but frequently
also on the cæcum and colon, covering an especially red and angry
mucosa. They may occur as simple patches, as ribbon shaped pieces, or as
hollow cylinders lining the entire circumference of the intestine. They
appear as if fibrillated, but contain abundance of granular matter and
seem to be composed mainly of mucus with albuminoid matter and probably
a little fibrine. The deeper layers, in contact with the inflamed
surface are soft and gelatinoid. It is alleged that coexisting wounds on
other parts of the body become covered by a soft pultaceous false
membrane.
_Diagnosis_ is based on the presence of the false membranes of a
considerable thickness, so that they can be distinguished from the film
of mucus which covers the fæcal balls in constipation or enteric
catarrh.
_Treatment._ Facilitate the secretion from the mucosa, and the
separation of the false membrane by giving 1 lb. Glauber salts, or give
this agent in doses of 5 or 6 ozs. per day. Calomel 1 dr. may be used
instead and has the additional advantage of acting as a disinfectant.
The alkaline carbonates or tartrates or even olive or castor oil may be
used as substitutes. Antiferments like salol, naphthol, salicylic acid,
and salicylate of soda have been prescribed to check the multiplication
of the germ. Flaxseed tea, elm bark, and other mucilaginous agents may
also be given. An easily digestible and laxative diet and a course of
bitters may follow.