The Flora of the Human Alimentary Tract 97 



48 (200S) 



The flora of the human alimentary tract: stomach, duodenum, 



jejunum. 



By B. ARONOVITCH, WARREN COLEMAN and MAX EINHORN. 



[From the Department of Medicine, University and Bellevue 

 Medical College and the Third Medical Division of 

 Bellevue Hospital, New York City.] 



The flora of the human alimentary tract has been the subject 

 of numerous investigations, but such studies during life have, of 

 necessity, been confined to the floras of the stomach and duode- 

 num and of the feces, except when operations or post-operative 

 fistula? have permitted approach to other portions of the tract. 

 Obviously, many levels of the alimentary tract have thus been left 

 unexplored. 



To obtain a complete picture of the flora of the human alimen- 

 tary tract in the living subject, and of the changes which the 

 flora undergoes as the intestinal contents travels downward, the 

 method pursued must permit the extraction at will of specimens 

 from any level of the intestine. The introduction of the Einhorn 

 intestinal tube makes it possible to fulfill these conditions. (It 

 may be stated parenthetically that we do not yet know the ex- 

 treme depth from which intestinal contents may be extracted. 

 We have been able to obtain material from a distance of 135 

 inches from the lips and hope to make extractions from as far as 

 the ileo-colic valve). 



Our studies were begun in the fall of 1920. So far, we have 

 confined our attention to the floras of the stomach, duodenum 

 and jejunum. Certain technical difficulties which we encoun- 

 tered may be referred to : 



Coiling of the tube in the stomach or below has occurred so 

 often we have concluded that the true position of the tube can 

 be ascertained only through roentgenograhpic examination. In 

 all of our subjects, such examinations have been made after 

 each extraction from below the stomach. 



Unless the distal end of the intestinal tube is kept closed until 

 the moment of extraction, it is impossible to tell when, or at what 

 level, intestinal contents first enters the tube. Once it enters, the 

 conditions obtaining within the intestine itself are removed and 

 the development of the flora is unrestrained. 



