INFECTIONS OF THE DIGESTIVE TRACT 207 



superficial necrosis of the mucous membrane of the 

 stomach and intestine, associated with the presence of 

 capsulatus in abundance. These necrotic areas most 

 often lie beneath the folds of the valvulse conniventes and 

 may occur with gas cysts. It does not seem likely that 

 B. aerogenes capsulatus is responsible for severe acute 

 inflammatory lesions of the intestine, but it is probable 

 that its activities will account for the subacute enteritis 

 that is so often present in cases that show large numbers 

 of the bacilli in the stools. It is certain that there are 

 instances of acute diarrhoea associated with very free 

 capsulatus multiplication and such diarrhoeas are com- 

 mon in persons with severe primary anaemia. 1 



In 1905 Tissier 2 described an acute intestinal affection, 

 especially frequent in nursling children, which he ascribed 

 to the presence of almost pure cultures of B. perfringens. 

 He claimed that in the treatment of these perfringens diar- 

 rhoeas which ordinarily ran a mild course the most effica- 

 cious therapeutic agency was the employment of cultures 

 of a lactic acid bacillus (B. paralacticus) . I have in a few 

 instances met with acute and subacute diarrhceal affec- 

 tions of children in which B. aerogenes capsulatus may per- 

 haps have been the cause of the intestinal derangement, 

 although in these cases pathogenic varieties of colon 

 bacilli have not been absolutely excluded as causal agents. 



1 1 am disposed to attribute this diarrhrea to an associated 

 streptococcus infection in these cases. One may observe cases 

 of advanced infection with the gas-bacillus without any diarrhoea; 

 indeed obstinate constipation is found in some of them. 



2 "Etude d'une varie"te" d'infection sur le nourrisson," Ann. 

 de I'lnst. Pasteur, xix, p. 273, 1905. 



