Abstract
SCOPE: This thesis is devoid of idyllic propensities.
The subject chosen is hackneyed, and the
treatment afforded to it is neither original
or entirely comprehensive. The work described
is the work of numerous institutions and was
undertaken with a strictly practical objective,
the control of the disease within one particular
Mental Hospital.
But the problems involved are not altogether
local. Bacillary dysentery is a disease of
world-wide distribution, and it clinical signs
have been known in this country for many
centuries. It was once a popular scourge,
but its epidemic violence died out with improved
sanitation and personal hygiene, so that major
epidemics are rare, except in Mental Hospitals,
which, on statistical evidence, harbour more
than 99% of the disease.
In Mental Hospitals the disease lingers on.
Much work is being done in the pruning of the
pathological growth and lopping off the grosser
excrescences, but no one appears able to strike
at the roots of the disease. When sporadic,
dysentery is an accepted concomitant of lunacy
when epidemic, the laboratory is cluttered with
faecal specimens, until, on the analogy of typhoid,
the scare is resolved on a solitary carrier and
a faulty drain. With a few notable exceptions,
there is no realisation that the epidemic is the
periodic phase of a constant activity, and no
effort is made to assess and control the endemic
level of the disease.
This we have attempted to do.