300 INFECTIONS OF THE DIGESTIVE TRACT 



epithelial nuclei in the faeces. The patients who suffer 

 from this condition usually do not tolerate well either 

 carbohydrates or acids. The intolerance of carbohy- 

 drates is shown by the occurrence of excessive intestinal 

 flatulence and sometimes slight diarrhoea after the use 

 of considerable meals of cereals or starchy foods. Sugars, 

 especially, are apt to be badly borne. 1 Probably this 

 intolerance is due in part to the production of acids. 

 There are cases in which the acid production from sugar 

 begins very rapidly in the mouth, and a certain amount 

 of butyric acid may be formed even in this situation, 

 owing either to the presence of B. aerogenes capsulatus 

 in the mouth or to the presence of aerobic butyric-acid 

 producers. Probably the tendency to diarrhoea ob- 

 served in some instances is due to the irritative action 

 of the acids formed from the decomposition of the 

 sugars in the small intestine. This intolerance is 

 naturally most marked hi those persons in whom evi- 

 dences of epithelial desquamation in the mouth and 

 elsewhere are most pronounced. The mucous mem- 

 branes of the digestive tract are almost constantly in a 

 state of excessive irritation, so that stimuli which in 

 normal people would meet with little response give 

 rise to an excessive peristalsis and diarrhoea. I think 

 it not improbable that in advanced cases of saccharo- 

 butyric putrefaction B. aerogenes capsulatus invades the 



1 There are instances in which excessive indulgence in carbohy- 

 drates is followed by mental depression and muscular prostration. 

 These symptoms appear to be simply a great exaggeration of 

 what is often noticed in healthy persons after similar indulgences. 



