TROPICAL INFANTILE DYSENTERY. 33 



diarrhoea, assimilation of food had not been satisfactory. Percentage feeding with 

 a large range of variation in both the proteid and fat content was tried without 

 success. Vomiting was frequent and emaciation became quite marked, so that 

 at the time of the development of the diarrhoea the child was already in a very 

 much exhausted condition. The diarrhoea lasted for about two weeks, with from 

 three to fifteen passages a day, and in a few instances small streaks of blood and 

 a considerable amount of mucus were found in the stools. 

 Cultures were made on the fourth day of the disease. 



The technique used in the first two cases was also employed in this 

 one; it will therefore be unnecessary to give a separate description in 

 each case. 



THE ORGANISM. 



Smears made from a portion of the mucus of the stool showed two 

 types of bacilli ; one a rather large organism with rounded ends, and 

 the other in comparison, extremely small. A series of four alkaline 

 bouillon tubes was inoculated with the material from the mucus portion 

 of the specimen and the tubes were allowed to stand four hours, when a 

 very slight cloud could be observed near the surfaces of the medium. 

 A series of four alkaline agar tubes at 45° C. was made from each tube, 

 plated and placed in the incubator for twenty-four hours at 37° C, 

 when I marked the colonies present; at the end of another twenty-four 

 hours several new colonies had appeared. There were very small and 

 of an intense blue color, the original colonies 24 hours old being creamy- 

 gray. Transfers to alkaline agar were made from each type of colony 

 and placed in the incubator for twenty-four hours, after which time 

 subcultures were made. The results are tabulated below. (See Table 

 I.) I have termed the 24-hour growth "C" and the 48-hour one "S". 

 Stained specimens of bacilli from each tube agreed in morphology with 

 those found in the smears made from the fresh mucus. 



Later, after obtaining the reaction of the organism in lactose bouillon, 

 I used another method for its isolation. Fermentation tubes were in- 

 oculated directly from the plate colonies, and after the reaction had 

 identified the organism, it was transferred from this medium to agar, 

 subcultures being made from the latter. 



A study of Table I shows the following characteristics which distinguish 

 Bacillus "8" from Bacillus coli. Bacillus "8" seems to be somewhat 

 smaller and more delicate than B. coli. Its motility is quite marked 

 and is of a wriggling and twisting character. Coagulation is delayed in 

 milk and the litmus present is completely reduced. It forms no gas in 

 lactose-litmus and there is profuse growth. The indol reaction is 

 negative. 



Fermentative tests were also made using the colon bacillus isolated 

 from the specimen taken from Case I as a control. 



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