338 PROCESSES OF THE LARGE INTESTINE. 



4. The metabolic products of the biliary coloring-matter, which are 

 especially abundant in all diseases that cause increased destruction of 

 erythrocytes, and which now no longer yield the Gmelin-Heintz reaction, 

 as well as the altered biliary acids. In diarrhea! stools, as, for example, 

 the green stools, the reaction, however, can often be readily demonstrated. 

 It indicates accelerated peristalsis. The meconium contains unaltered 

 bilirubin, biliverdin, glycocholic and taurocholic acids. 



5. Unaltered mucin and nuclein and, as a metabolic product of the 

 latter, xanthin-bases ; nuclein especially after a diet of bread ; in addition, 

 cylindrical epithelial cells from the alimentary tract in various stages of 

 digestion; further, fat-globules at times. Crystals of cholesterin and of 

 coprosterin are rare. The less intimately the mucus is admixed with 

 the feces, the lower down in the intestine is its source. 



6. After the ingestion of a large amount of milk, as well as after a 

 diet of fat, crystalline needles of calcium-salts of the fatty acids, thus 

 calcium-soaps, are found constantly in the feces, even in infants. When 

 courses of treatment with milk have been pursued undigested masses of 

 casein and fat have besides been observed to be present. Further, com- 

 binations of ammonia with the acids resulting from putrefaction already 

 mentioned are among the substances constantly present in the feces. 

 Larger masses of fat in the feces indicate accelerated peristalsis. 



7. Among the inorganic residue, the readily soluble salts, which 

 therefore are readily diffused, are rare in the feces; thus sodium chlorid 

 and other alkaline chlorids, the phosphoric as well as the sulphuric com- 

 binations. On the other hand, the insoluble combinations, principally 

 ammoniomagnesium phosphate, neutral calcium phosphate, yellow- 

 colored calcium-salts, calcium carbonate and magnesium phosphate, 

 constitute 70 per cent, of the ash. The large amount of alkalies and 

 earths contained- in the feces is noteworthy, three-quarters of which are 

 in combination with carbon dioxid and organic acids. These are derived 

 only in smallest part from the secretions of the intestinal mucous mem- 

 brane. By far the greatest part of the ash, however, is derived from 

 the constituents of the food. According to Rey, from 20 to 50 per cent, 

 of solutions of calcium-salts, injected into the blood or subcutaneously, 

 is excreted by the glands of the large intestine in the dog; 0.2 gram of 

 iron is present daily. 



In the presence of a fistula in the large intestine, Robert and Koch observed, 

 in the feces: sodium, calcium, magnesium, iron; phosphoric, sulphuric, hydro- 

 chloric acids; soaps, neutral fat, fatty acids, mucin, albumin, epithelium, traces 

 of ethereal sulphates, together almost one gram daily. At times the excretion 

 of inorganic substances is so abundant as to form incrustations upon other fecal 

 matter. Under such circumstances either ammoniomagnesium phosphate is 

 present alone, in large crystals, or magnesium phosphate is mixed with it. Par- 

 ticularly the ingestion of rye-bran, in bread, which contains these substances 

 in large amount, causes this result. Charcot's crystals are found in the presence 

 of entozoa. 



8. Bacteria are present in abundance; yeasts are seldom absent. 



For the identification of the individual bacteria, Escherich has developed 

 pure cultures from the intestinal contents of infants, Bienstock from those of 

 adults. In the intestine of infants, fed upon mother's milk exclusively, the 

 bacterium lactis aerogenes (Fig. 126,2) produces, particularly in the upper portion, 

 where milk-sugar is still unabsorbed, acetic acid, together with carbon dioxid, 

 hydrogen and marsh-gas. Lactates are transformed into butyrates. The 

 bacterium also produces acetic acid from starch. A characteristic feature of the 



