600 GASTRO-INTESTINAL BACTERIOLOGY 



To summarize, the important effects to be accomplished by a liberal 

 carbohydrate diet in those infections where the decomposition of 

 proteins or protein derivatives by bacterial activity leads to* chronic 

 or acute illness of intestinal origin are a change in the metabolism 

 of the offending organism resulting in the formation of lactic and 

 other acids in them in place of putrefactive products, and a gradual 

 replacement of the proteolytic and pathogenic types by bacteria of 

 the fermentative varieties. 



Another type of intestinal disturbance depends upon an unusual 

 or an excessive decomposition of carbohydrate. The excessive forma- 

 tion of acid within the intestinal tract by an overgrowth of aciduric 

 bacteria is well illustrated in young infants, especially those fed upon 

 too much maltose. 1 The dietary treatment of such cases is too obvious 

 to require further remarks. A group of cases which vary in severity 

 from mild, long-continued diarrhea of several years' duration to very 

 severe acute bloody diarrhea with great prostration are apparently 

 caused by an overgrowth of the gas bacillus in the intestinal tract. 

 This organism is relatively intolerant of lactic acid, and a diet prac- 

 tically free from carbohydrate, rich in protein, and reenforced by 

 a liberal consumption of very acid buttermilk usually effects a rapid 

 improvement in the acute cases, and a gradual improvement in those 

 cases which are of months' or years' duration. Members of the Mucosus 

 Capsulatus Group of bacteria may also, by overgrowth, set up a fer- 

 mentative type of diarrhea which resembles that of the gas bacillus 

 in its general features. The dietary treatment of these cases is like 

 that of gas bacillus diarrheas. 



1 Kendall, Boston Med. and Surg. Jour., 1910, clxiii, 322. 



