INFECTIONS OF THE DIGESTIVE TRACT 289 



does not occupy the entire intestinal tract, as may be 

 shown in diarrhoeal stools which contain colon bacilli 

 as well as B. bifidus. It is uncertain in how far the re- 

 tardation in growth and the myasthenia which are 

 characteristic of these cases are explicable through the 

 intoxication induced by the absorption of excessive 

 quantities of indol or phenolic substances. I am dis- 

 posed to think these bodies are an important factor in 

 determining the undue fatigue. The retardation in 

 growth may have hi part a similar origin, but it is prob- 

 able that this is partly the effect of a failure of the or- 

 ganism to utilize food normally, owing to the excessive 

 decompositions that occur in the intestinal tract. No 

 matter how much food is given, the excessive bacterial 

 changes rob the organism of enough caloric potential 

 to make normal growth impossible. 



In the treatment of these cases it is necessary to be 

 patient. It is essential to improve the character of the 

 digestive processes before one can reasonably hope to 

 secure a gain in weight and strength. Carbohydrates 

 should be permitted in only very small amount and 

 chiefly in the form of well-cooked rice or hominy or 

 Huntley and Palmer's breakfast biscuits. It may be 

 advantageous for a time to peptonize the milk in order to 

 secure early absorption. Moderate quantities of chicken 

 or beef or mutton may be permitted, but all meat should 

 be given in a finely divided form. It sometimes has 

 seemed best, in children as old as five or six years of age, 

 to allow only two meals in the course of the day, these 

 being rather generous. It is helpful to practice high irri- 



