464 THE F^CES IN DISEASE. [BOOK II. 



The stools in In typhoid fever, the diarrhoea probably depends 

 typhoid fever. p ar tly on diminished absorption of water and partly 

 upon the transudations which result from the inflammatory process 

 set up by the products of the specific organisms which are the cause 

 of the disease. The stools may contain blood and necrotic portions 

 of the mucous membrane. They are said often to contain ammonium 

 carbonate and to exhibit under the microscope crystals of ammoniaco- 

 magnesium phosphate. According to Brieger, they contain no skatol. 

 The faeces of typhoid fever contain the characteristic bacillus, 

 bacillus typhi, first accurately described by Gaffky 1 . The researches 

 of Brieger 2 shew that this bacillus, like the bacterium coli commune, 

 decomposes sugar with the production of lactic acid. Whilst 

 however this latter bacterium yields dextrogyrous acid (viz. sar- 

 colactic acid), the bacillus of Gaffky yields laevogyrous paralactic 

 acid (Blachstein 3 ). In the first edition of this book three isomeric 

 lactic acids were described, viz. ethylene-lactic acid, and the two 

 ethylidene-lactic acids, to wit, the optically inactive ethylidene- 

 lactic acid or lactic acid of fermentation, and the optically active 

 dextrogyrous ethylidene-lactic acid or sarcolactic acid. This, which 

 was also called paralactic acid, may now with convenience be called 

 dextrogyrous paralactic acid. In 1890, Schardringer succeeded in 

 obtaining (as a result of the fermentation of cane sugar by a bacillus, 

 discovered accidentally in water) the hitherto unknown laevogyrous 

 ethylidene-lactic acid, which forms salts which are dextrogyrous 

 (sarcolactic acid, on the other hand, being dextrogyrous forms lae- 

 vogyrous salts). So far as is at present known, the only pathogenic 

 organism which produces laevogyrous lactic acid, is according to 

 Blachstein, Gaffky's Bacillus typhi. From cultures of the bacilli of 

 typhoid fever, Brieger 4 separated a poisonous base, to which he as- 

 signed the name typhotoxin and the formula C 7 H 17 lSfO 2 . When in- 

 jected into guinea-pigs and mice, typhotoxin produces a lethargic 

 condition, paralysis, and fatal diarrhoea. In addition, active toxal- 

 bumins appear to be produced in cultures of the typhoid bacillus 

 (Brieger and Frankel). 



The stools in I n Asiatic cholera, the faeces assume the character 

 of the so-called ' rice-water stools,' i.e. they present the 

 appearance of a turbid, flocculent liquid, from which bile is absent, 

 in which the microscope reveals the presence of a large amount of 

 epithelium shed by the intestinal villi, and bacteriological analysis 

 the presence of the cholera spirillum. The liquid faeces contain very 



1 M. Gaffky, Mittheilungen aus dem Kaiserl. Gesundheitsamte, Vol. n., quoted by 

 Blachstein. 



a Brieger, Ueber Ptomaine, Th. in. (1886), p. 8^. 



3 Dr Blachstein, 'Contribution a la biologic du bacille typhique' (Travail du 

 laborat. de M. Nencki a 1'Institut Imperial de M6decine Expe"rimentale), Num. 1 and 2, 

 Extraite des Archives des Sciences Biologiques, Vol. i., St Petersburg, 1892. 



4 Brieger, ' Zur Kenntniss der Bildung von Ptomamen und Toxinen durch patho- 

 gene Bacterien,' Sitzungsber. d. Berl. Akad. d. Wissenschaft. Jan. 1889. 



