MORBID ALTERATIONS IN DIGESTIVE ACTIVITY. 



339 



feces is the slender bacterium coli commune (Fig. 126, i), provided with from 

 one to three flagella, which forms lactic and formic acids, together with acetic 

 acid, and at times exerts a pathogenic action. 



In the feces of adults Bienstock found first of all two varieties of large bacilli 

 pig. 126 3, 4) resembling the bacillus subtilis in size and appearance, differing 

 from the latter only in the form of its pure culture, by its manner of sporulation 

 and by an absence of independent movement. These two bacilli are distinguish- 

 able macroscopically only by the form of this culture, which takes the shape 

 A ^ 2 a ra P e > or of a mesentery. Neither possesses any fermentative activity 

 A third, micrococcus-hke, small, slowly multiplying bacillus (bacillus coprogenus 

 parvus) was present in three-quarters of all of the stools. The fourth variety is 

 the specific bacterium of proteid decomposition (bacillus putrificus coli) which 

 is wanting in the feces of infants, and which with the production a fecal odor 

 gives rise to the putrefactive products of proteids. Only this and no other causes 

 these processes in the intestine; yet it does not decompose casein and alkali- 



% 



3 < 



/ 



FIG. 126. i, Bacterium coli commune-, 2, Bacterium lactis aerogenes; 3, 4, the two large Bienstock bacilli with 

 partial endogenous spore-formation; 5, the various stages of development of the bacillus of proteid outre- 

 faction. 



albuminate. The evolution of this bacterium is represented in Fig. 126, 5, a-g; 

 of which the stages c and g are, however, wanting in the feces and are encoun- 

 tered only in artificial cultures. 



If the feces are simply examined microscopically, without special precautions, 

 the following are found as normal saprophytes: the bacterium coli commune, 

 the staphylococcus aureus; frequently, also, varieties of proteus, at times with 

 infective properties; in addition, other bacteria, whose entrance in part through 

 the anus is possible: the bacillus butyricus, often staining blue with iodin, in 

 feces rich in starch, and other small, spherical and rod-shaped schizomycetes, 

 staining similarly. After the ingestion of uncooked food of various kinds, Lembke 

 was able to verify the presence of as many as 73 different bacteria in the intestine. 



In human beings, with accidentally acquired intestinal fistulas or an artificial 

 anus (intestinal fistula involving the colon), opportunity is afforded to study 

 the changes in the intestinal contents with greater precision. 



MORBID ALTERATIONS IN DIGESTIVE ACTIVITY. 



The ingestion of food may be prevented by spasm of the muscles of mas- 

 tication (usually as a symptom of general convulsions), by strictures of the 

 esophagus, either from corrosive cicatrices (after the swallowing of caustic fluids) 

 or from neoplasms, especially carcinoma. Inflammatory affections of any kind in 

 the mouth and pharynx may also seriously interfere with the ingestion of food. 

 Inability to swallow occurs as a symptom of disease of the medulla oblongata, 

 in consequence of paralysis of the center for the motor nerves (facial, pneumogastric 

 and hypoglossal) and of that for the sensory nerves through which pass reflex 

 impulses (glossopharyngeal, pneumogastric and trigeminal). Irritation or ab- 

 normally heightened stimulation of this area may cause spasmodic swallowing 

 and a feeling of constriction in the throat (globu's hystericus). 



The secretion of saliva is diminished in conjunction with inflammation 

 of the salivary glands, occlusion of their ducts by concretions (salivary calculi) , 

 etc.; further, under the influence of atropin and daturin, in consequence of which 

 the secretory (not the vasomotor) fibers of the chorda tympani appear to become 

 paralyzed. Slight fever may increase the amount of saliva, though the amount 

 of ferment may be lessened; fever of more marked degree diminishes both, while 



