100 INFECTIONS OF THE DIGESTIVE TRACT 



As will be pointed out in dealing with the methods of 

 diminishing chronic excessive intestinal putrefaction, 

 those measures which are designed to secure prompt 

 digestion and prompt absorption from the small intestine 

 are of the greatest significance in limiting bacterial de- 

 compositions* 



The administration of a cathartic which acts imper- 

 fectly (that is, which carries partly digested food from 

 the small intestine into the colon without, however, 

 securing an evacuation) leads to conditions similar to 

 those following an excessive meal. In some persons 

 this miscarriage of a cathartic is followed by headache 

 and flatulence, in others by more serious signs of intoxi- 

 cation such as weakness in the muscles. In normal 

 persons these effects are relatively slight; in persons 

 whose digestive tracts are the seat of infection with 

 putrefactive anaerobes the evidence of excessive fer- 

 mentation and putrefaction is much more pronounced. 



THE PHENOMENON OF SUBSTITUTION 



I am convinced that what may be termed the phenom- 

 enon of substitution of flora in the digestive tract is a 

 common and significant occurrence in the course of many 

 derangements of the digestive tract. By substitution is 

 meant the temporary replacement of one type of micro- 

 organism normally abundantly present in the digestive 

 tract by an allied form which, though perhaps normally 

 present in small numbers, never assumes a dominant place 

 during health. The substitution may be complete or in- 

 complete and may be a temporary or a prolonged phe- 



