172 BACTERICIDAL ACTION OF GASTRIC JUICE. [BOOK II. 



cholera ; the same result follows the introduction of pure cultures 

 into the intestine. These interesting facts appear, at first sight, to 

 stand in opposition to the belief or, rather we should say, to the 

 decisive experience of the most careful and trustworthy observers, 

 that the contagium of cholera is in general introduced into the 

 organism through the alimentary canal. A little reflection will, 

 however, readily dispose of the apparent inconsistency between the 

 results of the experimental researches of R. Koch 1 and of Nicati and 

 Rietsch and the experience of physicians. 



Drinking water contaminated by the dejections of cholera 

 patients appears to be, in the immense majority of cases, the medium 

 of infection. Water is continually introduced into the stomach at a 

 time when digestion is in abeyance and the organ free from gastric 

 juice ; moreover, the dilution which any trace of acid must undergo 

 when considerable quantities of water are drunk will eventually 

 serve to protect the cholera bacilli of which the water is the 

 vehicle. 



The bacilli which are apparently directly, or through the products 

 of their vital activity, the materies morbi of typhoid (B. typhi), of 

 diphtheria (Loffler's B.), and of tetanus (B. tetani of Kitasato) are all, 

 apparently, injuriously affected or destroyed by digestion in gastric 

 juice. In the presence of albuminous substances, the hydrochloric 

 acid of the gastric juice, which combines with them, loses to some 

 extent its efficacy as a germ destroyer, and the organisms, above 

 referred to, may thus retain their pathogenic activity. 



I 



GASTRIC DIGESTION IN SPECIAL DISEASES. 



1. Gastric Digestion in Fevers. 



This has been made the subject of experimental inquiries and 

 direct observations. We may say, in general, that in febrile affections 

 the quantity of gastric juice is diminished: that the hydrochloric 

 acid is often altogether absent or very much diminished : that the 

 pepsin on the other hand is not altered 2 . The reaction of the gastric 

 juice was sometimes found neutral or even alkaline (Uffelmann), and 

 in a case reported by von den Velden 3 the acid reaction was due to 

 lactic acid (the case was one of typhoid). 



With these results agree well the facts ascertained by Manassein 4 , 

 who made animals febrile by injecting putrid matter into the blood 



1 R. Koch, Deutsche med. Wochenschrift, 1884, No. 45. 



2 Leube, Volkmann's klin. Vortrfige, No. 62. 



3 Berlin, klin. Wochenschrift, 1877, No. 42. 



4 Virchow's Archiv, Vol. 56, p. 413. 



