Acute dysentery

　　1. The history of unclean diet and contact within one week before the onset of the disease, as well as the local prevalence of the disease. The infectious source of acute bacterial dysentery is the patients and carriers of the disease, with Shigella bacteria excreted into the outside through feces and transmitted through the digestive tract (faeco-oral route).

　　2. Escherichia coli can survive on vegetables, fruits, rice, and bread for several days, even more than ten days, and can reproduce on grapes, strawberries, cucumbers, tomatoes, cold jelly, meat jelly, etc. Therefore, consuming raw and cold foods contaminated with E. coli can lead to foodborne or waterborne outbreaks.

　　1. Acute bacillary dysentery is often accompanied by varying degrees of dehydration, acidosis, and electrolyte disorder.

　　2. Chronic bacillary dysentery has symptoms such as abdominal pain and distension. The number of bowel movements is frequent, with obvious mucus stools, but the systemic toxic symptoms are not prominent.

　　3. A few patients may develop joint swelling and pain 1-2 weeks after onset, presenting as non-suppurative and migratory. If accompanied by fever, urethritis, and conjunctivitis, it is called Reiter's syndrome, which is related to the immune response induced by infection.

　　The incubation period of acute bacillary dysentery varies from a few hours to 7 days, most of which are 1-2 days; it can generally be divided into the following three types:

　　1. Acute toxic type bacillary dysentery:It is more common in children aged 2-7 years, and adults may also occur occasionally. Generally, the onset is acute, the development is rapid, the toxic symptoms are severe, while the gastrointestinal symptoms may not be severe. High fever, occasionally with an abnormally low body temperature. It is divided into four types according to the prominent site of microcirculatory disorders:

　　(1) The encephalitic type accounts for most of the toxic dysentery. In the early stage, there may be irritability, drowsiness, pale complexion, increased muscle tone, accompanied by convulsions, normal or slightly high blood pressure, and in the late stage, coma, even brain herniation.

　　(2) The lung type is mainly due to microcirculatory disorders in the lungs, also known as shock lung. The incidence rate is low, and the mortality rate is high, often occurring between 16-24 hours of the course, characterized by progressive dyspnea, hypoxemia, which is generally not relieved by oxygen inhalation.

　　(3) Shock type is more common in adults, with cyanosis of the extremities or extremities, coldness, thin and rapid pulse, low blood pressure, small pulse pressure difference, and reduced urine output. A few are of high output and low resistance type.

　　(4) Acute common type bacillary dysentery is also known as acute typical bacillary dysentery, with symptoms mainly of acute onset, aversion to cold, fever, nausea, vomiting, accompanied by abdominal pain, initially in the umbilical area or the whole abdomen, later shifting to the lower left abdomen. Physical examination often shows tenderness in the lower left abdomen. Diarrhea is frequent, initially yellow and loose stools, later with mucus and pus, small in amount, accompanied by urgent need to defecate.

　　2. Mixed type bacillary dysentery:Among the above three types, the occurrence rate of any two types existing simultaneously or sequentially is low.

　　3. Chronic bacillary dysentery:Mostly due to incomplete treatment or spontaneous remission of acute bacillary dysentery, becoming chronic bacillary dysentery, with a course lasting over 2 months. Symptoms include loss of appetite, abnormal defecation, varying between dry and loose stools, and rarely mucus. Generally, there is no abdominal pain, only a hidden pain or intestinal colic before defecation, which disappears after defecation. Some patients may have symptoms such as insomnia, frequent dreams, forgetfulness, and neurasthenia.

　　The etiology of acute dysentery is mostly due to external invasion of damp-heat and epidemic toxins, internal injury from unclean and cold food, damaging the spleen and stomach, intestines, leading to accumulation of damp-heat, obstruction of visceral Qi. The heat-toxin and epidemic toxin converge internally, scorching the intestines, causing injury to the collaterals, and blood and Qi stasis transforming into pus and blood. Among those affected by epidemic toxins, the onset is more acute and severe. Excessive heat-toxin can obscure the clear orifices, induce wind and convulsions, and even lead to the critical condition of external exhalation and internal closure.

　　1. Immunofluorescence bacteriophage method is positive;

　　2. Under the microscope, the feces show a large number of red blood cells and leukocytes, a few with phagocytes. The culture of Shigella is positive;

　　3. In the acute phase of blood picture, the count of peripheral blood leukocytes and neutrophils increases.

　　1. Diet

　　1. Dietary therapy for dysentery

　　(1) Ingredients: Equal parts of single clove garlic and coptis. Usage: Grind together into fine powder, make into pills with rice porridge. Take 3-6 grams per dose, three times a day.

　　(2) Ingredients: Equal parts of single clove garlic and coptis. Usage: Grind together into fine powder, make into pills with rice porridge. Take 3-6 grams per dose, three times a day.

　　(3) Ingredients: 50 grams of purple garlic, appropriate amount of syrup. Usage: Peel the garlic, mash it into a paste, soak in 100 milliliters of warm water for 2 hours, filter with gauze, and add half the amount of syrup. Adults take 80-100 milliliters a day, divided into 4 servings; children take 15-40 milliliters a day, divided into 3 servings.

　　(4) Ingredients: 10 grams of tea leaves, 60 grams of hawthorn, 3 slices of ginger. Usage: Boil and add sugar to drink, one dose per day, taken in 2-3 servings. Indications: Dysentery and bacterial food poisoning.

　　(5) Ingredients: 15-20 grams of green tea leaves. Usage: Brew and drink as tea. For severe cases, add 30 grains of glutinous rice and a little salt, stir-fry in a pot until yellow, then boil with water, make the taste bitter and salty, and drink the juice all at once. Take once a day for mild cases, twice or three times for severe cases.

　　(6) Ingredients: 15 grams of tea leaves, 50 grams of porophyllum ajacis, 30 grams of brown sugar. Usage: Boil and drink as tea, for 3-8 days consecutively.

　　(7) Ingredients: 5 grams of green vegetables, 10 grams of ginger, 30 grams of black plum meat. Usage: Cut the black plum into pieces, finely chop the ginger, put them in a thermos with tea, pour boiling water over, cover and steep for half an hour, then add appropriate amounts of brown sugar and drink while hot, three times a day. Note: Also effective for amebic dysentery.

　　(8) Ingredients: 10 grams each of green tea and lonicera japonica, 6 grams each of rose and tangerine peel, 3 grams each of jasminum sambac and licorice. Usage: Infuse with boiling water, cover and steep for 10-20 minutes before drinking. Drink 3-5 times a day. For children, reduce the dosage accordingly.

　　(9) Ingredients: 9 grams of tea leaves, 60 milliliters of white grape juice, 10 milliliters of ginger juice, 30 grams of honey. Usage: Boil the tea leaves for 1 hour and collect 100 milliliters of juice, mix with the other juices and take once.

　　(10) Ingredients: 100 grams of green tea, 25 milliliters of白酒. Usage: Boil green tea with 700 milliliters of water for 20 minutes, remove the residue, concentrate to 75 milliliters, add white wine after cooling. Take 1-2 milliliters every 4-6 hours, until cured.

　　(11) Ingredients: 2 sour pomegranates, 30 grams of honey. Usage: Mash the pomegranate and squeeze out the juice, mix well with honey, and take with warm water. Twice a day, for several days consecutively.

　　(12) Ingredients: Appropriate amounts of fresh radish, rice vinegar, and sugar. Usage: Peel the radish, rinse with cool water, cut into thin slices, add appropriate amounts of rice vinegar and sugar, mix well and eat, twice a day.

　　2. Diet principles

　　Diet should be easy to digest, rich in nutrition, sufficient in water, and non-irritating. And eat less and more meals.

　　3. Diet taboo

　　(1) In the acute stage, abdominal pain and vomiting are obvious, and light fluid diet should be adopted, such as thick rice gruel, 5-10% fried flour paste, lotus root starch, light fruit juice, vegetable juice, light tea water, etc. Avoid eating milk, soy milk and sweet drinks.

　　(2) In the improvement period, vomiting stops, the frequency of defecation decreases, and nutritious liquid diet or low-fat and residue-free semi-liquid diet can be eaten, such as milk, soy milk, egg pudding, egg soup, oil-free liver puree soup or meat puree soup, etc. Eat 4-5 meals a day, drink yogurt, which is beneficial to the disease.

　　(3) In the convalescent period, defecation has basically returned to normal. It is advisable to eat easily digestible semi-liquid diet or soft rice, and cooking should still be fine, fine, soft, and easy to digest. Eat more purple garlic, you can eat raw apple puree, but other fruits should be limited. Avoid eating raw and cold, hard, greasy, fried food and spicy and irritating food too early. Avoid eating foods rich in rough fiber and easy to produce intestinal bloating, such as celery, chives, soybean sprouts, coarse grains, sweet potatoes, potatoes, radishes, etc.

　　First aid

　　1. Gastrointestinal isolation should be carried out until the stool culture is negative twice, and the utensils and appliances used by the patient should be used exclusively and strictly disinfected. The stool should be treated with lime.

　　2. Rest in bed, liquid diet, drink plenty of dilute salt water.

　　3. Take 0.5g of Coptis chinensis daily, 3 times a day; or 0.5g of pipemidic acid, 3 times a day.

　　4. Symptomatic treatment:

　　(1) For fever patients, physical cooling treatment should be adopted.

　　(2) For convulsions and coma, special care should be taken, remove foreign objects from the mouth, and keep the respiratory tract unobstructed.

　　(3) For shock patients, take a supine position, slightly lower the head, keep warm and send them to the hospital for emergency rescue.

　　5. Emergency patients should be sent to the hospital for further diagnosis and treatment.

　　Second, Traditional Chinese Medicine treatment for acute dysentery

　　1. Isolation treatment for gastrointestinal tract, avoid greasy and刺激性 food.

　　2. Single and proven prescriptions:

　　(1) Wash the fresh Portulaca oleracea, add an appropriate amount of garlic, and crush it to make juice for consumption, 2-3 times a day;

　　(2) Decoct Herba Sempervivum for tea drinking;

　　(3) Take 30 grams of Sophora flavescens and Phellodendron amurense, decocted in water for consumption, 1 dose/day;

　　(4) Take 30g of purple garlic, crush it and dilute it with a little water for consumption.