INFECTIONS OF THE DIGESTIVE TRACT 309 



more rapidly than where either condition is alone present. 

 Not only do the nervous symptoms come on earlier, but 

 there is a relatively early loss in weight and power. 

 The indications of premature senility maybe pronounced. 

 It is probable that atrophic processes are not limited 

 to the fatty, muscular, and blood tissues. It seems 

 probable that the cells of the liver and of the kidney 

 undergo premature degenerative atrophy in these cases. 

 This is doubtless the result of chronic parenchymatous 

 changes due to constant exposure of the cells to cyto- 

 lytic toxic agents present in very small amounts at any 

 one time but acting constantly. We are still far from a 

 full understanding of the effects of enterogenic poisons on 

 different types of protoplasm. One tends, for example, 

 to assume that the destruction of red blood cells, in 

 the course of chronic or acute infections of the intestine 

 with the gas-bacillus, is due to the direct hsemolytic 

 action of hsemolyzing agents formed in the intestine. 

 It is possible, nevertheless, that the destruction of red 

 cells is sometimes accomplished through a process of 

 phagocytosis which is made possible by injuries to red 

 cells inflicted by special opsonins. 1 



The derangements of the nervous system which have 

 been mentioned as concomitants of the combined in- 

 dolic and saccharo-butyric form of excessive intestinal 

 putrefaction mental depression and muscle fatigue - 



1 Sir A. E. Wright tells me that he has observed pronounced 

 phagocytosis of red cells in a case of pneumococcus infection 

 associated with a pernicious type of anaemia. The subject of 

 phagocytosis of red cells has lately been investigated by Hektoen 

 (Journ. of Infect. Dis., iii, p. 721, 1906). 



