188 INFECTIONS OF THE DIGESTIVE TRACT 



types of bacteria in the fermentation tubes. In one 

 instance in which such an overgrowth of the fermenta- 

 tion tubes was regularly observed and in which the move- 

 ments regularly showed the presence of excessive num- 

 bers of epithelial cells, it was found that the patient had 

 for many months been infecting himself daily from an old 

 abscess next a carious tooth. Although the abscess was 

 treated surgically, the improvement in the clinical con- 

 ditions was very slow, and after a period of six months 

 under very favorable conditions of outdoor life evi- 

 dences of streptococcal infection still persisted to some 

 extent. In this case loss of weight and strength, mental 

 depression, and moderate anaemia were the prominent 

 clinical conditions. The movements contained in ad- 

 dition to streptococci somewhat excessive numbers of 

 B. aerogenes capsulatus. 



The presence of large numbers of intestinal strep- 

 tococci and diplococci in the faeces is a prominent 

 feature in some cases of pernicious anaemia. The 

 significance of this is not yet clear, partly because the 

 streptococcal infection has been associated in these 

 cases with the presence of greatly excessive numbers 

 of putrefactive anaerobes, especially B. aerogenes cap- 

 sulatus. It seems probable that a streptococcus in- 

 fection of the intestinal tract may greatly contribute 

 to bring about a deterioration in the physical condition 

 of a patient already infected with the gas-bacillus. In 

 several instances of severe anaemia some of them 

 of the pernicious type a prolonged streptococcal 

 diarrhoea has been observed to precede the onset of 



