112 



Scientific Proceedings (119). 



almost entirely upon the saliva swallowed (where the bacterial 

 content of the food may be disregarded). It would be expected 

 that the greatest multiplication of bacteria and maximum numbers 

 would be attained in the " interdigestive" phase, when the stomach 

 is relatively at rest and the secretion of acid is at a minimum. 

 Accordingly, therefore, the fasting contents should show the 

 highest bacterial count. But such is not the case. As a matter 

 of fact the last fractions, whether saliva be removed or not, 

 contain a far greater number of bacteria, and this is additional 

 evidence that the continual swallowing of saliva (which contains 

 millions of bacteria per c.c.) is in reality the factor which deter- 

 mines the bacterial content of the stomach at such a time. Again, 

 the fact that the bacterial numbers where saliva was removed, 

 were so small as to be negligible is significant when it is noted 

 that the secretion of acid is without much influence, i.e., only 2 

 bacteria appear where the total acidity is as low as 12 and as 

 high as 70. All these considerations mentioned point to the fact 

 that the saliva is the most important single factor in influencing the 

 bacterial content of the stomach under the conditions employed. 

 Similar results were obtained when these tests were made 

 on a healthy normal individual and on other manic patients 

 having very low acidity. The most important consideration, 

 however, is that these patients having a very low acidity would 

 be precisely the type of subjects, therefore, in which bacteria 

 might gain a foothold and make the stomach a focus of infection. 

 Judging from the results when saliva is removed, such is far from 

 being the case. 



A qualitative study of the types of bacteria found in the saliva, 

 and by the fractional method of analysis, in the stomach, serves 

 as additional evidence in support of these findings. Consequently, 

 when the Rehfuss method is employed, the stomach cannot be 

 considered a focus of infection except where lesions are known to 

 exist. 



