INFECTIONS OF THE DIGESTIVE TRACT 219 



tion of acetone. This appears, however, to be an 

 exceptional occurrence. Up to the present time it has 

 been observed only in the case of material derived 

 from two individuals. In one of these the bacteria with 

 which the medium was inoculated came from a child 

 suffering from well-marked chronic intestinal putrefac- 

 tion of the marantic type with the development of a large 

 abdomen. 



The other instance in which the flora gave rise to the 

 formation of acetone was one of advanced anaemia. 

 Why acetone was obtained from a culture in dextrose 

 bouillon and calcium carbonate but not in dextrose 

 bouillon without calcium carbonate was not clear. The 

 flora from this case also gave rise to the production of 

 acetone in milk to which calcium carbonate had been 

 added. The presence of sugar is not necessary to the 

 production of acetone by intestinal flora, as is shown 

 by the fact that it has been obtained from plain 

 bouillon. 



It is not at present clear what significance should be 

 attached to the ability of the intestinal bacteria in cer- 

 tain cases to produce acetone. The observations here- 

 tofore made do not furnish us with any evidence that 

 acetone is ever produced in the human organism in the 

 intestinal tract through the activity of microorganisms. 

 Nevertheless the finding of acetone under the conditions 

 just mentioned suggests the possibility that under some 

 conditions this ketone may be produced in the digestive 

 tract. I do not know of any observations that have 

 heretofore been made which have shown the formation 



