A criteria for clinical evaluation of antibiotics on symptoms of bacillary dysentery. II. Severity of course (author's transl)

Abstract

In the concept “Severity” of Bacillary Dysentery, evaluation of the length of the course is included.It is useful to express the length of the course by a numerical score not only to evaluate the severity of disease but also to take an objective view of antibiotic effect.Now, a score of 13.4 is assigned to the occurrence of fever in the overall clinical course (Table 1), which is influenced by the degree of fever in the initial stage of illness (Table 3). Similarly, to the days required for normalization of frequency of diarrhea a score of 22.9 is assigned, while 56.7 score is assigned to the days for disappearance of pathological products. In other words, if the total marks for the course of dysentery are 100, the significance of the course of each symptom is shared as the marks shown above. The marks of pathological products are divided into 24.7 for mucus, 18.2 for blood, and 13.8 for pus, respectively, and on calculating the total, the score corresponding to the days required for each disappearance must be added.In such a way, relative importance of each component of illness is summarized in Table 5 as the score with regard to the initial severity.Applying these marks to each case and getting the total score for the clinical course, the severity of the clinical course of Flexner dysentery in the 1930's and in the 1970's was compared. The result was that the cases with severe illness markedly decreased in these days, especially in male children. Classified by symptoms, the latter has become less severe in decreasing order of Fever, Diarrhea and Pathological products respectively.Next, the course between Flexner and Sonne Dysentery in the 1970's was compared. The result was that Sonne was plainly mild and the differentiation was marked, on being classified by symptoms, in order of Pathological products, Diarrhea and Fever.