T84 W. McKIM MARRIOTT 



The stools contain relatively little free fat, negligible amounts of pro- 

 tein, no carbohydrate and no free organic acids. More than half of the 

 total solid material may consist of the soaps of the higher fatty acids 

 chiefly palmitic and stearic. Calcium soaps predominate but magnesium 

 sodium and potassium soaps are also present. In addition there are 

 considerable amounts of calcium phosphate. There is relatively little 

 neutral fat (Holt, Courtney and Fales(c),, Freund(c), Bahrdt). The 

 bacteria are few in number and gram negative. The small number of 

 bacteria is doubtless due to the fact that bacterial growth is not luxuriant 

 in a relatively dry medium. 



The conditions favoring the formation of stools of the type described 

 are an alkaline condition in the gastro-intestinal tract, stasis in the large 

 intestine, the presence of considerable amounts of fats in the food and 

 sufficient mineral base, especially calcium. 



An alkaline condition of the intestine may occur as the result of ex- 

 cessive secretion of the alkaline pancreatic juice, bile and succus entericus. 

 Such an excessive secretion may be brought about according to Bahrdt and 

 McLean by the presence of large amounts of fat in the small intestine 

 especially if the fat is one which contains a considerable percentage of 

 glycerides of the lower or volatile fatty acids. Support of this hypothesis 

 is furnished by the fact that the character of the stools changes when 

 the fat is decreased in amount, or fats such as vegetable oils (Freund(fr) 

 (c)), or the fat of breast milk which contains less of the lower fatty acids 

 (Huldschinski(a) (&), Niemann(d)), are substituted for cow's milk fat 

 in the food (Freund(6), Bahrdt). 



Casein when fed in excess leads to the passage of alkaline stools. This 

 is believed by Freund(fe) to be due to its effect in stimulating alkaline in- 

 testinal secretions, but as purified casein has much less effect in this re- 

 spect than has calcium caseinate (ordinary milk curd) it is probable 

 that the presence of the base calcium is here the more important factor. 

 When considerable amounts of carbohydrate are present in the gastro- 

 intestinal tract, bacterial growth is favored and acid products are formed 

 in considerable quantity and this may prevent the intestinal contents 

 from becoming alkaline and thus eliminate one of the factors essential 

 for the production of soap stools. There is some experimental evidence 

 (Bahrdt) that calcium and magnesium salts are secreted by the large 

 intestine and that when the contents of the colon are alkaline in reaction 

 such sodium and potassium soaps as may be present are converted into in- 

 soluble calcium and magnesium soaps. When the intestinal contents are 

 alkaline, there is less active peristalsis than in the presence of acid, and 

 absorption of water is more complete on account of the longer period 

 of time during which material remains in the intestinal tract. It also 

 allows for the fairly complete conversion of the alkali soaps into alkali 

 earth soaps (Bahrdt). 



