312 INFECTIONS OF THE DIGESTIVE TRACT 



regarding the etiology of a disease upon the bacterial 

 conditions that present themselves after the disease has 

 become established. I observed that it sometimes 

 happens in the course of a pernicious anaemia that 

 the numbers of B. aerogenes capsulatus in the faeces 

 undergo so great a decrease in the course of treatment 

 that the microscopical faecal fields present a nearly 

 normal appearance with respect to this organism. 

 Hence the failure to find the gas-bacillus in large excess 

 after a patient has for some weeks or months had the 

 benefit of treatment by diet and rest does not necessarily 

 exclude a preceding infection. 



I believe the most intense period of the saccharo- 

 butyric process sometimes precedes the development 

 of a pernicious anaemia by a considerable length of time. 

 The explanation of this seemingly paradoxical view lies 

 in the fact that the normal defenses of the organism 

 must be greatly impaired before a pernicious type of 

 anaemia can arise. The bacterial process involved in 

 breaking down these defenses (which include the ability 

 of cells to bind, oxidize, and pair with enterogenic 

 poisons) are intensive and of long duration. After a 

 time there develop symptoms of weakness which make 

 it necessary for the subject of the gas-bacillus infection 

 to live with much greater regard for hygienic conditions; 

 for example, with more rest, more out-of-door life, and 

 a more restricted dietary. In consequence of these 

 changes the intensity of the putrefactive process is 

 mitigated. The quantity of injurious products absorbed, 

 including those that are haemolytic, may become so 



