This is generally resultant from an acute attack, though the amebic
form may be subacute from the onset.
=Pathologically=, the coats are generally thickened, especially the
submucosa and the muscular coats being hypertrophied. Ulcers are
usually present, although there are cases in which there are no ulcers.
Cicatricial contractions sometimes follow and the calibre of the bowels
is reduced, strictures being rare.
=Symptoms.=—There is a progressive loss of flesh and strength, little
or no tenesmus, slight, colicky pain and extreme anemia. The stools
contain mucus, at times blood, and the bowels move from two to twelve
times a day.
=Diagnosis.=—The history of the initial symptoms will establish the
diagnosis. It is not always possible to distinguish between chronic
dysentery and chronic diarrhea. The duration is from a few months to
several years, although osteopathic treatment has proven very efficient
in many instances.
=Treatment.=—Rest and a liquid diet are most essential. Foods that are
easily assimilable and nourishing, with a minimum amount of residue,
are required. Beef juice, beef peptonoids and peptonized milk are the
types of food. Change of air, hygienic measures and environment are
important.
In cases that become chronic, the spinal column oftentimes exhibits
lesions above and below the lumbar region. Undoubtedly they are
lesions of secondary importance in comparison to the lumbar lesions,
but it is important that they be corrected. The treatment requires
thorough, careful work of the disordered spinal column and lower ribs.
Occasionally a slight kyphosis is present in the dorso-lumbar region
that demands persistent work in order to correct it. An occasional
rectal injection is beneficial, especially in cases that have slight
ulceration of the sigmoid flexure or rectum causing colicky pains and a
few loose stools in the morning, the patient being fairly comfortable
during the rest of the day.