Bacilli Resembling the Typhoid Bacillus 619 



Toxic Products. — Vaughan and Cooley* have shown that the 

 toxin of the colon bacillus is contained in the germ-cell and under 

 ordinary conditions does not diffuse from it into the culture-medium. 

 The toxin may be heated in water to a very high temperature without 

 injuring its poisonous nature. They have devised an apparatus in 

 which enormous cultures can be prepared and the bacteria pulver- 

 ized.f Of such a preparation 0.0002 gram will kill a 200-gram 

 guinea-pig. 



Pathogenesis. — The bacillus begins to penetrate the intestinal 

 tissues almost immediately after death, and is the most frequent 

 contaminating micro-organism met with in cultures made at autopsy. 

 It may spread by direct continuity of tissue, or via the blood-vessels. 



Although under normal conditions a saprophyte, the colon bacillus 

 is not infrequently found in the pus in suppurations connected with 

 the intestines — as, for example, appendicitis — and sometimes in 

 suppurations remote from them. 



In intestinal diseases, such as typhoid, cholera, and dysentery, 

 the bacillus not only seems to acquire an unusual degree of virulence, 

 but because of the existing denudation of mucous surfaces, etc., finds 

 it easy to enter the general system, with the formation of remote 

 secondary suppurative lesions in which it is the essential factor. 

 When absorbed from the intestine, it frequently enters the kidney 

 and is excreted with the urine, causing, incidentally, local inflamma- 

 tory areas in the kidney, and occasionally cystitis. A case of ure- 

 thritis is reported to have been caused by it. 



In infants cholera infantum may not infrequently be caused by 

 the colon bacillus, though sometimes in this disease other bacteria 

 play an important r61e (B. dysenteriae?). 



The bile-ducts are sometimes invaded by the bacillus, which may 

 lead to inflammation, obstruction, suppuration, or calculus formation. 



The colon bacillus has also been met with in puerperal fever, 

 Winckel's disease of the newborn, { endocarditis, meningitis, liver- 

 abscess, bronchopneumonia, pleuritis, chronic tonsillitis, urethritis, 

 and arthritis. 



An interesting summary of the pathogenic effect of Bacillus coli 

 can be found in Rolleston's paper in the " British Medical Journal" for 

 Nov. 4, igii, p. 1186. 



In a certain number of cases general hemic infection may be caused 

 by Bacillus coli. In 1909 Jacob§ published an analysis of 39 such 

 cases, and in 1910 Draper || increased the number to 43. Wiens** also 

 reported 6 cases and Maherft i case, so that the total now stands 50. 



* "Jour. Amer. Med. Assoc," 1901; "American Medicine," 1901. 



t "Trans. Assoc. Amer. Phys.," 1901. 



t " Kamen-Ziegler's Beitrage," 1896, 14. 



§ "Deutsch. Archiv. f. Klin. Med.," 1909, xcvii, 303. 



|l "Bull, of the Ayer Clin. Lab. of the Penna. Hosp.," 1910, No. 6, p. 21. 



** "Munch, med. Woch.," 1909, lvi, 962. 



ft "Med. Record," 1909, Lxxv, 482. 



