288 INFECTIONS OF THE DIGESTIVE TRACT 



may find excessive numbers of positive diplococci. It 

 should be especially noted that the common anaerobic 

 putrefactive organisms are present in very small num- 

 bers. It is not certain that the bifidus-\ike organisms 

 found in these cases of chronic indigestion in children 

 represent the preponderance of a type which should, 

 under normal conditions, gradually be replaced by colon 

 bacilli, but the idea is one which forces itself strongly 

 upon one. It is possible that the organism may have 

 acquired other characters than those pertaining to the 

 bifidus bacilli of the nursling. 



Associated with the Gram-positive bifidus-\ike or- 

 ganisms in the faces one may find moderate numbers 

 of positive diplococci or short streptococcal chains. 

 These diplococci may appear in considerable abundance 

 in the fermentation tubes or may give rise there to an 

 abundance of streptococcus forms. In one apparently 

 typical case which was under observation for a long time, 

 the child at the height of the disease (when indicanuria 

 was very marked) showed in the faecal fields considerable 

 numbers of these Gram-positive diplococci. After a 

 period of six months, upon a strict proteid and fat diet, 

 the diplococci were no longer present in the fields. It 

 was also noticeable that indican had disappeared from 

 the urine although the patient had gained very little in 

 weight and strength. 



Whether in these cases the production of indol is due 

 to the colon bacilli present in the upper part of the tract 

 or whether it is due in part to other types of organisms 

 is by no means clear. B. bifidus in these cases certainly 



