PATHOLOGICAL VARIATIONS. 



285 



causes the lactic acid fermentation with the evolution of C0 2 and H, in the upper part of 

 the canal where some milk-sugar is still unabsorbed. In the evacuations is the characteristic 

 slender Bacterium coli commune (fig. 205, 1). In addition, occasionally there are other bacilli, 

 cocci, spores of yeast, and a mould. 



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Fig. 205. 

 1, ^Bacterium coli commune ; 2, bacterium lactis aerogenes ; 3 and 4, the large bacilli of 

 ut , A Bienstock, with partial endogenous spore-formation ; 5, the various stages in the develop- 

 ment of the bacillus which causes the fermentation of albumin. 



In the faeces of an adult, Bienstock detected two large forms of bacilli (fig. 205, 3, 4), closely 

 resembling Bacillus subtttis in form and size, but distinguished from it only by the form of 

 its pure cultivation, by the mode of growth of its spores, and by the absence of movements. 

 These two forms can be distinguished microscopically by the mode of their cultivation, which 

 is either in the form of a grape or a flat membrane. These two do not excite a fermentative 

 action. A third micrococcus-like, small, very slowly-developing bacillus occurs in three-fourths 

 of all stools. A fourth kind (absent in sucklings) is the specific bacillus (184, III.), causing 

 the decomposition of albumin, resulting in the products of putrefaction and a faecal odour. 

 This is the only bacillus that excites these processes in the intestine ; but it does not decompose 

 casein and alkali-albumin. In fig. 205, 5, a-g, the stages in the development of this bacillus 

 are represented, but the stages from c and g are absent in the faeces, and are found only in 

 artificial cultivations. 



If the faeces are simply investigated microscopically and without special precautions, there 

 are other fungi, some of which may be introduced through the anus. In stools that contain 

 much starch, the bacillus butyricus, which is tinged blue with iodine, occurs ( 184), and other 

 small globular or rod-like fungi, which give a similar reaction (Nothnagel, Uffelmann). 



The changes of the intestinal contents have been studied on persons with an accidental 

 intestinal fistula, or an artificial anus. 



[The following scheme from Krukenberg shows graphically the reaction of the contents of the 

 various parts of the alimentary canal, and also the distribution of the ferments. ] 



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Amylotytia torannt ^qq PATHOLOGICAL VARIATIONS. A. The 



Milk coagulating foment taking "of food may be interfered with by spasm of the 



Pepstn muscles of mastication (usually accompanied by general 



' Trypsin spasms), stricture of the oesophagus, by cicatrices 1 after 



Bacteria swallowing caustic fluids (e.g., caustic potash, mineral 



acids), or by the presence of a tumour, such as cancer. 

 Inflammation of all kinds in the mouth or pharynx interferes with the taking of food. Inability 

 to swallow occurs as part of the general phenomena in disease of the medulla oblongata, in con- 

 sequence of paralysis of the motor centre (superior olives),for the facial, vagus, and hypoglossal 

 nerves, and also for the afferent or sensory fibres of the glossopharyngeal, vagus, and trigeminus. 

 Stimulation or abnormal excitation of these parts causes spasmodic swallowing, and the disagree- 

 able feeling of a constriction in the neck (globus hystericus). 



B. The secretion of saliva is diminished during inflammation of the salivary glands ; occlu- 

 sion of their ducts by concretions (salivary calculi) ; also by the use of atropin, daturin, and 

 during fever, whereby the secretory (not the vaso-motor) fibres of the chorda appear to be 

 paralysed ( 145). When the fever is very high, no saliva is secreted. The saliva secreted 

 during moderate fever is turbid and thick, and usually acid. As the fever increases, the dia.- 

 static action of the saliva diminishes. The secretion is increased by stimulation of the buccal 



