BACTERIAL METABOLISM WITHIN THE BODY 713 



and possibly even in the tissues, may take place. Feeding a diet rich 

 in carbohydrate certainly tends to keep the glycogen reservoir in the 

 liver, muscles and elsewhere at a high level. The normal blood sugar, 

 nearly 0.1 per cent in man, would likewise tend to be kept at or near its 

 maximal level, through continuous repletion from the glycogen deposits 

 and additions from the intestinal tract. One-tenth of one per cent of 

 glucose continuously present in the general circulation would abundantly 

 supply the minute requirements of the typhoid bacilli therein present. 

 Under such conditions it is difficult to conceive of the failure of the 

 organisms to utilize such a readily assimilable source of energy. 35 The 

 living typhoid bacilli in the circulation would become potentially lactic 

 acid bacilli. Furthermore, inasmuch as glucose appears to exist in simple 

 solution in the plasma, it would diffuse readily into the tissues. It is 

 possible, even probable, that the outside of necrotic foci containing the 

 organisms in the spleen, liver and other organs would receive glucose. 

 Whether this glucose would penetrate to the depths of such foci cannot 

 be stated. A large carbohydrate intake stands in some very direct rela- 

 tion to the favorable progress of the disease. Sugar can not neutralize 

 toxins, however, although they do prevent the formation of toxins in 

 many well known instances. 



The diminution in signs of toxemia and the "prevention of or com- 

 pensation for toxic destruction of protein and body cells," noticed by 

 Shaffer and Coleman, has significance in the light of the effect of utiliz- 

 able carbohydrate upon the metabolism of the typhoid bacillus. It must 

 be recognized that the "toxic" action observed in typhoid fever rests 

 ultimately with the growth of the organisms, because they alone incite 

 the disease, typhoid fever. An amelioration of the signs and symptoms 

 of toxemia suggests direct interference with the formation of the toxic 

 agent, whatever it may be. Looking at this reduction of toxic phenomena 

 from the viewpoint of the shifting of the metabolism of the typhoid 

 bacillus from proteolytic [toxicogenic] to fermentative, it will be seen 

 that the continuous supply of glucose, furnished by the Shaffer-Coleman 

 high calorie diet, provides exactly the chemical basis for its accomplish- 

 ment. 



Attention is redirected again at this point to the general theory, attested 

 to by physiologists, that "utilizable carbohydrate spares body protein" and 

 the essential agreement of the physiological and bacteriological response 

 under parallel conditions. 



85 Metabolic studies of typhoid bacilli in sterile, defibrinated blood, and in sterile 

 blood serum (containing the normal percentage of blood sugar) have shown that the 

 protein constituents are left practically intact until the glucose is fermented. In this 

 connection, the observations of McGuigan and von Hess that glucose may be obtained 

 from the circulating blood in animals by dialysis through collodion memuranes is of 

 significance. They conclude: "Dialysis of normal circulating blood shows the blood 

 sugar to be entirely free and to exist in simple solution in the water of the plasma." 

 Sugar in this state is available for energy in the blood stream by typhoid, or in fact 

 any other, bacteria which can utilize it. 



