634 PATHOGENIC MICROORGANISMS 



attributed to these microorganisms are various diarrheal conditions, such 

 as cholera nostras and cholera infantum. The relation of these maladies 

 to the colon bacillus has been particularly studied by Escherich, 14 

 but satisfactory evidence that these bacilli may specifically cause such 

 conditions has not been brought. While it is not unlikely that under 

 conditions of an excessive carbohydrate diet, colon bacilli, may aggravate 

 morbid processes by a voluminous formation of gas, they do not, of 

 themselves, take part in actual putrefactive processes. It is likely, 

 therefore, that in most of the intestinal diseases formerly attributed 

 purely to bacilli of the colon group, these microorganisms actually play 

 but a secondary part. 15 



It is equally difficult to decide whether or not these bacilli may be 

 regarded as the primary cause of peritonitis following perforation of 

 the gut. Although regularly found in such conditions, they are hardly 

 ever found in pure culture, being accompanied usually by staphylococci, 

 streptococci, or other microorganisms, whose relationship to disease is 

 far more definitely established. Isolated cases have been reported, 

 however, one of them by Welch, in which Bacillus coli was present in 

 the peritoneum in pure culture without there having been any intestinal 

 perforation. 16 Granting that the bacillus is able to proliferate within 

 the peritoneum, there is no reason for doubting its ability of giving rise 

 to a mild suppurative process. 



Inflammatory conditions in the liver and gall-bladder have fre- 

 quently been attributed to the colon bacillus. It has been isolated from 

 liver abscesses, from the bile, and from the centers of gall-stones. Welch 

 has reported a case of acute hemorrhagic pancreatitis in which the 

 bacillus was isolated from the gall-bladder and from the pancreas. 



In the bladder, Bacillus coli frequently gives rise to cystitis and 

 occasionally to ascending pyonephrosis. No other microorganism, in 

 fact, is found so frequently in the urine as this one. It may be present, 

 often, in individuals in whom all morbid processes are absent. The 

 condition is frequently observed during the convalescence from typhoid 

 fever. It may disappear spontaneously, or cystitis, usually of a mild, 

 chronic variety, may supervene. 



Localized suppurations due to this bacillus may take place in all 

 parts of the body. They are most frequently localized about the anus 

 and the genitals, and are usually mild and amenable to the simplest 

 surgical treatment. 



"Escherich, loe. cit. 



15 Herter, "Bact. Infec. of Digest. Tract," N. Y., 1907. 



16 Welch, Med. News, 59, 1891. 



