﻿IX, B. 6 Crow ell: Intestinal Lesions 457 



while in the other 3 cases the infection of the peritoneum is sup- 

 posed to have entered through the thinned wall of the intestine 

 at the site of ulceration. Of the 2 perforations, 1 occurred 

 in the descending colon near the sigmoid flexure and 1 in the 

 vermiform appendix. The latter case also had liver abscesses. 

 The 3 cases referred to in the table as dying of toxaemia ap- 

 parently died as the result of the severity of the intestinal lesions. 



BACILLAEY COLITIS 

 Table V. — Causes of death in 25 cases of bacillary colitis. 



ToxaBmia 13 



Complications : 



Acute peritonitis 3 



Abortion 2 



Postpartum sepsis 1 



Intercurrent diseases: 



Tuberculosis 2 



Malaria 2 



Noma 1 



Leprosy 1 



Fourteen of these cases occurred in children under 7 years 

 of age. In 12 of the cases there was involvement of the lower 

 portion of the ileum, this involvement varying from a hyperse- 

 mia to marked diphtheritic inflammation. 



The cases referred to as dying of toxaemia are those in which 

 no essential lesions were found outside of the intestine, save 

 degenerative lesions, and 6 of those cases had a bronchopneu- 

 monia. Stated roughly it may be said that bronchopneumonia 

 is present in from one-third to one-half of the cases of bacillary 

 colitis in this series, dying as the result of the severity of the 

 intestinal lesions. In none of the cases presenting an acute peri- 

 tonitis was this lesion an extensive one, and it apparently rep- 

 resented only a terminal infection which had passed through 

 the diseased colon. 



The occurrence of 3 cases associated with pregnancy indicates 

 the danger of bacillary colitis occurring during pregnancy and 

 that the two conditions may influence each other unfavorably. 



In 1 case intestinal tuberculosis coexisted with the bacillary 

 colitis, and in 1 case entamcebic and bacillary colitis were both 

 present. It is possible that more careful investigation would 

 enable one to recognize a superadded bacillary infection in a 

 greater number of the cases of entamcebic colitis, whereas it 

 is rather difficult of detection in routine examinations of a large 

 number of bodies, on account of both the anatomical and bac- 

 teriological difficulties in diagnosis. 



