THE RELATION BETWEEN BACILLUS ENTERITIDIS 
SPOROGENES OF KLEIN AND DIARRHOEA 
By E. E. GLYNN, M.A., M.B. 
The bacillus enteritidis sporogenes was discovered by Dr. Klein during 
certain investigations concerning the cause of an epidemic of diarrhoea. The 
following is an abstract of the epidemic taken from the report by Dr. Andrewes, 
Health Officer to St. Bartholomew's Hospital. f ' On the night of October 
27, 1895, a sudden outbreak of diarrhoea of a severe type occurred amongst the 
in-patients of St. Bartholomew's Hospital. Out of twenty-eight wards fifteen were 
affected. The total number of cases during the night and following morning was 
fifty-nine. The outbreak ceased as suddenly as it began, and by mid-day on October 
28 it was practically over.' Clinically, the earliest symptom in nearly all cases was 
abdominal pain. 'This was followed in the course of half an hour or more by 
diarrhoea. Vomiting was conspicuously absent in the great majority of the cases. 
The disorder was intestinal, not gastro-intestinal. In some instances the bowels 
were opened six or eight times in the course of twelve hours, but in the majority 
of cases only two or three times. The stools were in most cases liquid and watery, 
and a considerable amount of mucous was present, In the more severe cases a 
considerable degree of prostration occurred. But in no case was the attack fatal, 
even when the patient had been previously suffering from severe disease.' 
On microscopical examination of the evacuations and also of the mucous 
discharge, a very large number of oval glistening spores were detected. These, Dr. 
Klein demonstrated by anaerobic cultivation, were derived from a hitherto unknown, 
and ' uncommon,' I organism, the bacillus enteritidis sporogenes. Moreover, milk 
cultures of this bacillus inoculated subcutaneously into guinea-pigs led to severe 
haemorrhagic oedema with gangrene, and death in about twenty-four hours. 
The main features of the outbreak pointed to ' the toxic character of some 
article of diet supplied to the patients alone,' for the nurses, with one exception, 
escaped. By process of exclusion the milk was suspected. Since none of this 
incriminated milk was available for bacteriological examination a sample ' taken from 
the same source as that supplied on October 27 was furnished by the company 
* Part of this article was presented to the University of Cambridge as a thesis for the degree of Bachelor of Medicine, 
t Medical Officer 's Repai r, Local Government Board, for 1895-96, p. 197-198. 
X Medical Officers Report, Local Government Board, for 1 895-96, p. 204. 
