186 INFECTIONS OF THE DIGESTIVE TRACT 



water are ordinarily quickly destroyed in the upper part 

 of the tract. 



During infancy the digestive tract is much less re- 

 sistant to streptococcus infections, and invasion of the 

 mucous membrane by streptococci is a frequent occur- 

 rence and may be associated with disturbances of al- 

 most any grade of severity. It has been shown by 

 Booker in this country and by Escherich in Germany 

 that some of the severest forms of infantile ileocolitis 

 are associated with streptococcus infections and are 

 probably dependent upon them. As the digestive tract 

 of the infant is readily damaged so as to become per- 

 meable by bacteria, it is not surprising that streptococcus 

 septicaemia is of frequent occurrence. The condition is 

 one which frequently but not necessarily ends fatally. 

 A less common result of the penetration of the intestinal 

 wall by streptococci is purulent peritonitis. 



In children there are some instances of severe ileo- 

 colitis in which streptococci appear to be the primary 

 inciters of disease. At least one may say that other 

 bacteria which might fall under suspicion, such as dysen- 

 tery bacilli and pathological types of colon bacilli have 

 not been found in the cases in question. It is doubtful, 

 however, whether the biochemical characters and viru- 

 lence of certain colon-like forms have received sufficient 

 attention in those cases which are regarded as instances 

 of pure streptococcus infections. In many examples of 

 infantile diarrhoea it appears clear that the streptococci 

 which are prominent in the stools are really secondary 

 invaders. Here the primary infection through colon 



