488 
together with the bile, it finds its way into the intestinal canal. Such 
an occurrence we have not as yet been able to prove in the case of 
dysentery. Dr. Amako in Kobe, made cultures from the bile and spleen 
of 16 cadavers dead of dysentery, but he never was able to demonstrate 
the presence of the bacillus and these experiments made the assumption 
probable that the organism of dysentery, unlike that of typhoid, can not 
find its way into the circulation. 
TYPES OF DYSENTERY BACILLI. 
The etiological importance of the dysentery bacillus as the causative 
factor in dysentery was first proven by Flexner? and by Strong ®* in 
Manila, and the latter author, at that time, had already strictly distin- 
guished between two types of dysentery—i. e., bacillary and amebic. 
The latter type, as a rule, takes a chronic course and amcebe, generally, 
can at all times be discovered in the stools, whereas the former is an 
acute disease the causative factor of which lies in the bacillus of dysentery. 
Kruse,‘ in 1901, first called attention to the fact that an organism discovered 
by him in Germany is not entirely identical with the one observed in Manila. 
During an epidemic of dysentery occurring in'a prison he encountered a second 
bacterium which differed from the Shiga-Kruse bacillus only in respect to its 
serum reaction; the latter organism he termed the pseudodysentery bacillus, 
and this variety was soon thereafter also discovered by Spronck® in Holland. 
Martini and Lenz® confirmed this observation of Kruse and even extended it, for 
Lenz’ succeeded in differentiating the Shiga-Kruse stem from the Manila one 
by cultural methods, in that he demonstrated that. the former did not, whereas 
the latter did, ferment mannite which he had placed in his culture media. Hiss 
and Russell,* independently of Lenz, but at the same time, showed that a 
bacillus, isolated by them from a case of infantile diarrhoea, and termed 
“bacillus Y,” differed from the Shiga-Kruse stem in its fermentive action on 
mannite, and following this publication a further paper by Hiss® appeared in 
which the author separated the bacillus of dysentery, which he had isolated from 
patients attacked by dysentery and infantile diarrhea, into three groups based 
upon cultures obtained on media containing, respectively, mannite, dextrose, mal- 
tose, saccharose, and dextrin. Gay” distinguished two groups of dysentery bacilli, 
founding his deductions on the bacteriolytic action of and the protection given 
by the immune serum, and finally Hiss,“ using the fermentative action on the 
above-mentioned carbohydrates, succeeded in giving a reliable classification; and 
* Phil. Med. Journ. (1900), Sept. 1, 6, 414. Also Bulletin of Johns Hopkins 
Hospital (1900), Oct., 11, 231. 
* Journ, Am. Med. Assoc, (1900), Aug. 25, 35, 498 and 501, also Circulars on 
Tropical Diseases (1901), No 1, Feb., Manila, P. I. 
* Deut. Med. Woch. (1901), 27, 370, 386, 637. 
° Baumgartnen’s Jahresbericht (1901), 17, 473. 
° Zeit. fiir. Hyg. u. Infect. (1902), 41, 540. 
7 Loc. cit., 540. 
°N. Y. Med. News (1903), Feb. 14, 82, 289. 
* Journ. Med, Research (1904), new series, 8, 12. 
* Univ, of Penn. Med. Bull. (1903), 16, 171. 
" Loe. cit., p. 1. 
