FECES 229 



There was also a decrease in intestinal putrefaction, 1 a fact which 

 indicates that at least a part of the bacterial deficit was made up of 

 putrefactive organisms. In some cases over 50 per cent of the total 

 nitrogen of feces has been shown to be bacterial nitrogen* 



Various enzymes have been detected in the feces. The first one so 

 demonstrated was pancreatic amylase. 3 The amylase content of the 

 feces is believed to be an index of the activity of the pancreatic function. 4 

 The excretion of this enzyme has been found to increase under the 

 influence of water drinking with meals. 5 Other enzymes which have 

 been found in the fec_es under various conditions are trypsin, rennin, 

 maltase, sucrase, lactase, nuclease and lipase. 6 In an abnormally rapid 

 transit of food through the intestinal tract, such as is seen in certain 

 diarrheas, nearly all of these enzymes may be detected. 



Some of the more important organisms met with in the feces are the 

 following: 7 B. coli, B. lactis aerogenes, Bact. Welchii, B. bifidus, and 

 coccal forms. Of these the first three types mentioned are gas-forming 

 organisms. The production of gas by the fecal flora in dextrose- 

 bouillon is subject to great variations under pathological conditions; 

 alterations in the diet of normal persons will also cause wide fluctuations. 

 Data as to the production of gas are of considerable importance in a 

 diagnostic way, although the exact cause of the variation is not yet 

 established. It should be borne in mind in this connection that gas 

 volumes are frequently variable with the same individual. For this 

 reason it is necessary in every instance to follow the gas production for 

 a considerable period of time before drawing conclusions. 8 While the 

 question of the study of bacterial flora of the feces is a question beyond 

 the range of this work, mention may be made here of the character of 

 the organisms observed by Gram staining of the stool after administra- 

 tion of different types of diet. It has been shown that when the diet 

 is markedly protein, the protein type of flora becomes predominant in 

 the stools. Gram-stained smears show a fairly equal distribution of 

 Gram-negative and Gram-positive organisms. Among the latter are 

 largely the subtiloid organisms with some of the Bact. Welchii, together 

 with a moderate number of diplococci and coccoid forms. Most of the 

 Gram-negative organisms resemble the B. coli. When the diet is 



1 Hattrem and Hawk: Arch. Int. Med., 7, 610, 1911; Blatherwick, Sherwin and Hawk: 

 loc. cit. 



2 MacNeal, Latzer and Kerr: Jour. Inf. Dis., 6, 123, 1909; Mattill and Hawk: Jour. 

 Exp. Med., 14, 433, 1911; Blatherwick and Hawk: Biochem. Bull., 3, 28, 1913. 



3 Wegscheider: Inaug. Diss., Strassburg, 1875. 



4 Wohlgemuth : Berl. klin. Woch., 47, 3, 92, 1910. 



'Hawk: Arch. Int. Med., 8, 382, 1911. 



Ury: Biochem. Zeit., 23, 152, 1909. 



7 Herter and Kendall: Journal of Biological Chemistry, 5, 283, 1908 



8 Herter and Kendall: loc. cit. 



