BACTERIAL DIGESTION IN THE INTESTINE 537 



found collapse are produced. These observations have led several inves- 

 tigators to believe that the persistent occurrence of bacterial fermen- 

 tation and the absorption of the resulting decomposition products of 

 protein into the blood ultimately cause arteriosclerosis and the other symp- 

 toms that accompany senescence. It is difficult at the present time to 

 know how much of this one ought to believe, although it can not be 

 doubted that putrefaction has an unfavorable action on the arteries, 

 and that an excessive degree of it causes the symptoms of ptomaine 

 poisoning. 



If the ptomaines have formed in the food before it is eaten, the symp- 

 toms develop in from one to five hours after the meal, but if the decomposi- 

 tion occurs in the intestine on account of bacteria that are taken at the same 

 time as the food, the ptomaines may not have developed sufficiently to 

 cause symptoms until from twelve to forty-eight hours; sometimes, how- 

 ever, they develop in an hour or so. Prominent among the symptoms is 

 usually diarrhea, which develops for the purpose of getting rid of the 

 offending bacteria and ptomaines. 



Actual infection of food with bacteria of the paratyphoid-enteritidis 

 type is much more common than poisoning by substances (ptomaines) that 

 have been generated in food before it is taken (Jordan 27 ). Meat, milk 

 and other protein foods are usually the carriers of the bacilli, and in most 

 of the accurately recorded cases the meat or milk was found to be 

 derived from animals suffering from enteritis or some other infection. 

 Sometimes, however, perfectly good food may become infected by 

 handling. Although the symptoms are usually acute, they may closely 

 simulate those of typhoid fever, and the effects of the attack may linger 

 for weeks or months. 



BOTULISM 



The commonest type of poisoning by substances actually present in the 

 food is that known as botulism. In this the gastrointestinal symptoms, as a 

 rule are not pronounced, indeed, paralysis of the intestinal tract with con- 

 stipation is the rule, but those affecting the nervous system, dizziness, 

 diplopia and other visual disturbances, with difficulty in swallowing, 

 are very prominent. The temperature and pulse are usually normal. 

 In practically all of the reported cases of botulism, the source of infection 

 has been food which after having been subjected to some preliminary treat- 

 ment, such as smoking, pickling, or canning, had been allowed to stand 

 for some time and then eaten without cooking. The Bacillus botulinus, 

 which is responsible for the production of the poisons or toxins, is a 

 strict anaerobe and is readily destroyed by cooking, as are also the 

 poisons. Antitoxins are formed by sublethal injections. Another but 



