492 



ANAEROBIC BACTERIA 



Pathogenesis. The pathogenesis of B. aerogenes capsulatus is very 

 variable. The production of emphysematous gangrene in contused 

 wounds and compound fractures is the best known of its pathogenic 

 properties. According to Achalme, 3 the organism has been isolated 

 from the blood stream in cases of acute articular rheumatism. This 

 observation has been made by others also. It has not been proven, 

 however, that the organism causes acute articular rheumatism. In 

 the intestinal tract 4 the organism occasionally produces disease which 

 varies in severity from a mild diarrhea to an extremely acute dysenteric 

 diarrhea. Epidemics of such diarrhea appear to have been traced in 

 a few instances to milk. 5 The organism appears to cause an intense 

 irritation in the intestinal tract, probably due to the production of 

 butyric acid, but there is no evidence that the intestinal infection is 

 a true toxemia. 6 Usually the organism is not invasive, but in a few 

 cases the mucosa of the large intestine has been distinctly involved. 

 The mucosa was enormously swollen and edematous and the 

 organisms were found deep in the submucosa. In one instance at 

 least the organism has been isolated from tonsils in a case of chronic 



1 Gas and acid. 



2 This table is in harmony with the view that the organism does not, as a rule, sporu- 

 late in media containing utilizable sugar. It is probable that the acid products of 

 fermentation inhibit sporulation, as Simonds has shown. 



3 Compt. rend., Soc. de biol., 1891, xliii, 651; 1897, xlix, 276; Ann. Inst. Past., 

 November 25, 1897. 



4 Howard (Johns Hopkins Hosp. Rep., 1900, ix, 461) states that the organism may 

 develop in the gastric or intestinal mucosa, especially under the folds of the valvulse 

 conniventes, and cause disintegration of the tissue. 



6 Klein, Annual Report of the Medical Officer of the Local Government Board, London, 

 1897-1898, No. 27, p. 210. 



6 Kendall and Smith, Boston Med. and Surg. Jour., 1911, clxiv, 306. Kendall, Day 

 and Bagg, ibid., 1913, clxix, 741. Kendall and Day, ibid., 753. Kendall, ibid., May 

 20, 1915. 



