TYPES OF CHRONIC EXCESSIVE INTESTINAL 

 PUTREFACTION 



i 



THE considerable vacations in the clinical manifes- 

 tations and pathological accompaniments of chronic 

 excessive intestinal putrefaction suggest that the etio- 

 logical conditions vary considerably in different cases. I 

 shall endeavor in the following pages to show that there 

 are grounds for the separation of different types of 

 intestinal putrefactive processes and that these grounds 

 are based on differences in the character of the putre- 

 factive products and in the bacteria concerned with these 

 processes. The classification which I offer is a tentative 

 one which may in time have to give way to one founded 

 on a fuller knowledge of the significant intestinal con- 

 ditions than we at present possess. In any event it 

 must undergo modification. It is, however, proposed 

 here in the belief that it will serve a useful purpose in 

 helping to classify cases of disease and in giving direction 

 to systematic study. 



It is a striking fact that while many cases of excessive 

 intestinal putrefaction are associated with the presence 

 of indican in the urine in large amount, there are other 

 cases of considerable gravity clinically which fail to 

 show much indican in the urine or may indeed be entirely 

 free from indicanuria during a long period of observa- 

 tion. I propose to divide cases of chronic excessive 



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