292 INFECTIONS OF THE DIGESTIVE TRACT 



prominence there which is not often observed in the case 

 of persons in good health. It seems not improbable 

 that the presence of these diplococci are of importance 

 to the process, but their precise relation to it cannot be 

 at present confidently stated. In some instances these 

 Gram-positive diplococci appear in the fermentation 

 tubes in great abundance, although they are not seen 

 in the faecal fields in such number as to attract special 

 attention. 



A very common phenomenon in cases of the saccharo- 

 butyric type of chronic excessive intestinal putrefaction 

 is the formation of only small volumes of gas in sugar- 

 bouillon fermentation tubes after these have been inocu- 

 lated with the mixed faecal flora. As already explained, 

 it has been our custom in routine work to study the 

 gas production on four sugar-bouillon tubes containing 

 dextrose bouillon, levulose bouillon, saccharose bouillon, 

 and lactose bouillon. The gas production in these 

 tubes has often fallen to one-half that observed ordinarily 

 in health, and the volume may even fall to one-quarter 

 or one-fifth the total gas production observed under 

 normal conditions. In a few cases some of the fermen- 

 tation tubes have contained no measurable amount of 

 gas. This is, however, an exceptional condition. The 

 explanation of this phenomenon of small gas production 

 in the fermentation tubes appears to lie in the diminu- 

 tion hi the number of living organisms of the B. coli 

 type that are present in the faeces. That the colon 

 bacilli are much reduced in numbers is evident in some 

 of the cases of saccharo-butyric putrefaction from the 



