This master thesis aims to show how a qualitative approach to early modern medical practitioners’ perspectives can provide a basis for a better understanding of the disease of dysentery. The focus is on: 1) How the disease of dysentery was described and how the challenge of dysentery was perceived. 2) What individual measure and commitments were taken for the patients and why. 3) How the cause of the disease was understood and explained. 4) How perspectives differed between physicians and surgeons.Of particular interest when it comes to the disease of dysentery is how the disease and its cause were perceived.Eleven texts written by mainly British medical practitioners from primary sources such as reports, logbooks and letters on dysentery written during the years 1740 - 1800 have been used for close readings and a qualitative analysis was performed on the collected data.The analysis showed (i) that medical practitioners expressed considerable interest in dysentery and in trying to understand it as a great suffering for individuals, for society and for humanity as a whole. (ii) Medical practitioners took treatment measures based on how they understood the cause of the disease outbreak. Either the dysentery was referred to internal causes, as sickness in organs, especially the organs that produced bodily fluids, or it was referred to external causes, as a sickness caused by heat, cold, weather, winds, air, climate, seasons, lunar position, etc. (iii) The cause of the disease was understood and explained both as an infection and as a pre-disposition for imbalances in body fluids. (iv) Both physicians and surgeons understood that the disease of dysentery was a global phenomenon and that the disease often was connected to the climate and weather. This standpoint was based on the fact that dysentery distinguished itself as an autumnal disease. Its eruption usually began with a few scattered cases in July, then increased in August and culminated in September. Theories about the disease, its causes and treatment did not differ significantly between physicians and surgeons. However, the views of different physicians did differ.The thematic map of understanding related to disease of dysentery, shows that medical practitioners’ knowledge, theories and ideas behind the medical practice of dysentery, have an ambiguity in the view of both the dysentery and the treatment of it. This was probably due to interpretation based both on observable causes of diseases, and on a more theoretical abstract meaning, where diseases to a greater extent was understood on the basis of symptoms and signs.It is suggested that regardless of the knowledge base of the individual medical practitioner, no one represented an independent knowledge base for their treatment of dysentery; rather they participated actively with each other in a mutually constitutive way in order to shape their understanding of the dysentery. This theses’ qualitative approach, allows dysentery patients and their medical practitioners via the texts of the medical practitioners, to offer very personal accounts of a highly contagious disease.

The soldier's diet in the Civil War has been known as poor, and a number of illnesses and disorders have been associated with it. However, a nutritional analysis placed within the context of mid-nineteenth century American nutrition has been lacking. Such an approach makes clear the connection between illness and diet during the war for the average soldier and defines the importance of nutrition's role in the war. It also provides a bridge from the American diet to the soldier diet, outlining correlations between the two and examining the influence of physicians, chemists, and health reformers on the Civil War diet. / Master of Arts

Call number: LD2668 .T4 1985 G733 / Master of Science

This thesis aimed to verify the causal association between "B. hampsonii" and the re-emergence of mucohaemorrhagic diarrhea in North American swine farms, to investigate the role of the intestinal microbiome as a predisposing factor for infection, to develop a porcine colon in vitro culture model and to apply this model in investigating early host-pathogen interactions. Two infection trials were conducted to determine the pathogenicity of "B. hampsonii" clade II and clade I. Weanling pigs were divided into control (n=6) and inoculated (n=12) groups. In each trial, pigs were inoculated with "B. hampsonii" clade II (tissue homogenate or pure culture) or clade I (pure culture) or sterile culture media. Animals were monitored for clinical signs of diarrhea and upon observation of bloody diarrhea they were necropsied for characterization of lesions. Fecal shedding of "B. hampsonii" was monitored throughout the trials using culture and quantitative real-time PCR. Pre and post-diarrhea fecal samples from the clade II infection trial were used to study the microbiome response to "B. hampsonii" infection and to determine if pre-inoculation microbiome composition differed between pigs that did or did not develop clinical disease. For in vitro model development, numerous factors associated with explant survivability in culture were investigated to develop a protocol for culture of porcine colon explants. The optimized model was used to study the first 12 hours of "B. hampsonii" clade II interaction with the host using a combination of histopathology and gene expression analysis. Pigs inoculated with "B. hampsonii" clade I (9/11) and clade II (9/12 and 8/12 in the tissue homogenate and pure culture experiments, respectively) developed mucohaemorrhagic diarrhea and colitis within 14 days of inoculation. In all trials, mucohaemorrhagic diarrhea was significantly more common in inoculated pigs than controls. No significant differences in richness, diversity or taxonomic composition distinguished the pre-inoculation microbiomes of affected or unaffected clade II inoculated pigs. After the development of diarrhea, the fecal microbiome of diarrheic pigs was more dense and had a had a lower Bacteroidetes:Firmicutes ratio when compared to inoculated but unaffected or control pigs. Cultured porcine colon explants displayed differentiated epithelium and crypts after 5 days in culture, while expressing GAPDH at a constant rate. For explants to thrive in vitro our results suggested the use of distal spiral colon, processed immediately after euthanasia, and cultured in an oxygen-rich gas mix with air-liquid culture interface in media containing antibiotics and antifungals. Explants exposed to "B. hampsonii" for 12 hours had a greater number of necrotic cells and thicker catarrhal exudate than control explants. Interaction of spirochaetes with the epithelium, necrotic cells and crypts was visible under optical microscopy, and a trend of increased expression of IFN-γ and e-cadherin in inoculated explants relative to control explants was observed. Taken together, results of this thesis demonstrate that "B. hampsonii" causes mucohaemorrhagic diarrhea in pigs and modulates their intestinal microbiome. The development of an in vitro infection model that replicates in vivo features facilitated the observation of the initial events in "B. hampsonii" interaction with the colon. When explants were exposed to "B. hampsonii" similar histological lesions to in vivo were observed. This system provides a powerful model for future studies of the pathogenesis of "B. hampsonii" and other enteric pathogens of pigs.

Amoebic dysenteri is a problem in developing countries and is caused by Entamoeba histolytica (E. histolytica) with symptoms such as diarrhea, vomiting and in worse case extra intestinal manifestation. Currently there are difficulties to diagnose E. histolytica infections in developing countries because PCR requires advanced and expensive and microscopy cannot distinguish E. histolytica from other harmless species of amoebas. The aim of this study was therefore to develop loop-mediated isothermal amplification (LAMP), which is similar to PCR but is performed at a single temperature and amplifies the target gene in less than an hour. LAMP was also compared to real time PCR. With a commercial kit, DNA were extracted from cultivated trophozoites and for the LAMP reaction, a colorimetric mastermix and six primers were used designed from 18S small subunit ribosomal RNA gene. With phenol red positive LAMP reactions showed a color change from pink to yellow and negative LAMP reactions remained pink. The sensitivity of LAMP for detection of E. histolytica was determined to be 80 pg/µl, which was ten times less sensitive than real time-PCR. The method was also shown to work on trophozoites with no DNA extraction and no non-specific amplifications were seen with DNA from G. lamblia, which showed some specificity. LAMP proved to be sensitive and easy to work with, but requires tightly closed tubes to avoid contamination and false positive results. To develop and evaluate the method LAMP for detection of E. histolytica, more studies are needed, including clinical samples and optimization.

Two disease regions existed on the Oregon Trail. Asiatic cholera impacted the Platte River flood plain from 1849 to 1852. Dysentery developed two endemic foci due to the decay of buffalo carcasses in eastern and middle Nebraska between 1844 and 1848, but later developed a much larger endemic region west of this Great Plains due to the infection of livestock carcasses by opportunistic bacteria. This study demonstrates that whereas Asiatic cholera diffusion along the Trail was defined primarily by human population features, topography, and regional climate along the Platte River flood plain, the distribution of opportunistic dysentery along the Trail was defined primarily by human and animal fitness in relation to local topography features. By utilizing a geographic interpretation of disease spread, the Asiatic cholera epidemic caused by Vibrio cholerae could be distinguished from the dysentery epidemic caused by one or more species of Salmonella or Campylobacter. In addition, this study also clarifies an important discrepancy popular to the Oregon Trail history literature. "Mountain fever," a disease typically associated with Rocky Mountain Spotted Fever, was demonstrated to be cases of fever induced by the same bacteria responsible for opportunistic dysentery. In addition, several important geographic methods of disease interpretations were used for this study. By relating the epidemiological transition model of disease patterns to the early twentieth century sequent occupance models described in numerous geography journals, a spatially- and temporally-oriented disease model was produced applicable to reviews of disease history, a method of analysis which has important applications to current studies of disease patterns in rapidly changing rural and urban population settings.