INFECTIONS OF THE DIGESTIVE TRACT 295 



reaction is probably due to the presence of an excessive 

 amount of hydrobilirubin. 



In consequence of the presence of the higher fatty 

 acids in the faeces in considerable amount, there may be 

 imparted to the contents of the lower bowel a slight acid 

 reaction. The reaction, however, may be neutral or 

 even alkaline. The fatty acids in question are neutral- 

 ized by bases formed in the course of putrefactive 

 processes and especially by ammonia, ammonium buty- 

 rate sometimes being formed in considerable amount. 

 It is probable that the production of ammonium buty- 

 rate in excessive amount acts as an irritant to the in- 

 testinal tract and may be the cause of a certain softness 

 of the movements 1 in cases of excessive saccharo-butyric 

 putrefaction or may even be responsible for a diarrhoaal 

 condition. It is, however, not clear that this is the sole 

 cause of such evidence of irritation, as other irritative 

 products may be associated with ammonium butyrate. 



The faeces in the condition under consideration usually 

 show the presence of little or no indol. Indol may be 

 wholly absent. More commonly there is a small amount 

 of indol, perhaps two or three milligrams in one hun- 

 dred grams of the intestinal contents. The quantity of 

 phenol may be slightly in excess of that normally found, 

 but this is, I think, not usually the case. In con- 

 sequence of the small absorption of indol the urine con- 



1 The consistence of the stools may be influenced by the liquefy- 

 ing action of the anaerobes on proteids. A normal stool may 

 stand in the laboratory for days without changing in consistency; 

 a stool containing a great excess of putrefactive anaerobes may 

 spontaneously liquefy in the course of a week. 



