BACILLUS ENTERITIDIS OF KLEIN 135 
have been bacillus enteritidis in a non-sporing state. Further, spores of normal 
virulence were also isolated from six out of six cases of cholera nostras in adults, three 
being fatal.* 
Now, if bacillus enteritidis produced the infantile diarrhoea, why were the 
spores apparently absent in the evacuations of seven out of eleven patients ? But 
assuming six cases of cholera nostras and four of infantile diarrhoea were due to this 
bacillus, why did seven of them die, whereas all the 291 persons attacked at St. 
Bartholomew's recovered, although at the time several were seriously ill from inter- 
current diseases ? Why, also, were the cultures of enteritidis obtained from the 
mild cases which recovered equally virulent to those obtained from the severe cases 
which died ? Indeed, considering the presence or absence of enteritidis spores in the 
evacuations, some evidence in support of the proposition that the bacillus was the 
agent producing the St. Bartholomew's epidemics and also, in certain instances, 
infantile diarrhoea and cholera nostras,]" was the fact that Dr. Klein believed they were 
absent in the normal evacuations ; a statement which he has since modified. J 
Dr. Andrewes, in 1896, investigated the anaerobic organisms existing in 
twenty consecutive cases of diarrhoea. § From one to three loopfuls of faecal matter 
were inoculated into grape sugar gelatine, heated between 78 and 8o° for ten 
minutes, and incubated anaerobically at 20 C. The only microbe constantly present 
was bacillus enteritidis sporogenes, or a 'variety'; it was isolated from twelve 
individuals. The 'variety,' as Dr. Klein pointed out, was most probably the true 
enteritidis growing atypically, as frequently obtains under certain conditions. I have 
attempted to summarise Dr. Andrewes' results. The spores of enteritidis were 
present in — 
(a) Four out of ten cases of acute diarrhoea with symptoms, often severe, 
of intestinal or gastro-intestinal irritation. 
(/;) Four out of six cases of diarrhoea without enteritis. 
(Y) In diarrhoea associated with catarrhal jaundice, also with gastric 
ulcer. 
(d) In a case of fatty diarrhoea, and in the watery offensive stool of a 
child. 
The results of inoculation are not stated in six instances ; in tour the cultures 
were of diminished virulence, in one non-pathogenic, while an anaerobic milk culture 
from the evacuations of a man who died with choleraic symptoms was exceedingly 
virulent. 
The explanation of the diminished virulence is the fact that the gelatin 
cultures, liquefied by the bacillus, were injected, and as the gelatine sometimes 
liquefied slowly, ' it is probable that some such cultures had lost their virulence. '^j 
* Medical Officer's Report, Local Government Board, 1897-98, p. 2 ',4. 
t Medical Officer's Report, Local Government Board, 1897-98, p. 211. 
% Medical Officer's Report, Local Government Board, 1898-99, p. 330. 
§ Medical Officer's Report, Local Government Board, 1896-97, p. 255-62. 
% Medical Officer's Report, Local Government Board, 1896-97, p. 260. 
