706 ARTHUR ISAAC KENDALL 



in which protein-liquefying organisms of the mesentericus and proteus 

 types, together with smaller numbers of other similar organisms, are 

 the prominent varieties met with. 



11. The putrefactive products formed by the facultative and purely 

 proteolytic types of intestinal bacteria comprise, in addition to unknown 

 substances, aromatic amins, fatty acids, and aromatic nuclei of amino 

 acids. Of these, histamin, tyramin and indol ethylamin are physio- 

 logically active even in minute amounts. Also, indol, phenol, paracresols, 

 and skatol are formed in recognizable amounts. The subsequent fate 

 of these substances within the body has already been discussed. 



4. Exogenous Intestinal Infections 



Bromatherapy. Thus far, emphasis has been placed upon the prin- 

 ciples underlying the general phenomena of bacterial metabolism, and 

 applications of these principles to the elucidation of the mutual and re- 

 ciprocal relations between diet and microbic response in the normal, or 

 nearly normal, digestive tract. 



An obvious extension of these principles to the therapeutics of ex- 

 ogenous and endogenous infections of the intestinal tract clearly presents 

 itself. The need for specific therapy in intestinal infections is very 

 great. The treatment of typhoid, cholera, dysentery, and other enteric 

 diseases is expectant and supportive. There are no serums or antitoxins 

 of proven value available, and chemotherapy is thus far unsuccessful. 

 There is clearly an important place in clinical medicine for procedures 

 of specific intervention which are in favor of the host, and antagonistic to 

 the microbe, once infection is established. The prevention of infection 

 does not of course enter into the discussion at this point, 



A theoretical basis for specific intervention in intestinal bacterial in- 

 fection resides in the relation of carbohydrate and protein sources of 

 energy to the production of benign or noxious products of metabolism by 

 pathogenic and parasitic bacteria. It will be remembered that diphtheria, 

 dysentery, cholera, typhoid, paratyphoid, colon, proteus, and many other 

 organisms form benign lactic acid from utilizable carbohydrate. They 

 are potentially buttermilk bacilli so far as the chemical products of their 

 growth are concerned, upon a suitable sugar diet. The removal of the 

 carbohydrate, however, is immediately followed by the formation of 

 nitrogenous, noxious products, many of which are poisonous. 



Available evidence indicates that the same metabolic phenomena are 

 involved in the intestinal culture in vivo and in the artificial culture 

 in vitro. The underlying principles are identical. "Utilizable - carl 

 hydrate protects protein from bacterial decomposition." 



This principle of the protective action of utilizable carbohydrate fc 



