i + 2 THOMPSON YATES LABORATORIES. REPORT 
considerable percentage of instances (about thirty-nine per cent.) of the typhoid 
cases wherein these stools had become, owing to constipation or convalescence, 
normally formed and solid, the spores were altogether absent in relatively consider- 
able amounts of faecal matter. And even in those instances of formed stools in 
which these spores were found to be present they could only be demonstrated by 
using large amounts of the faecal matters.' * 
Do these results indicate some cause or connection between the presence of 
enteritidis spores and the formation of the typical fluid typhoid stools ? If so, it is 
curious that the virulence of enteritidis cultures obtained from the cases of 
' diarrhoea ' with ' typical ' stools was normal in twenty,f' and diminished in three 2 , 
instances ; while on the other hand, it was normal in fourteen- 5 and diminished in 
two 4 cultures from ' solid ' stools, diarrhoea being absent. 
In my opinion the simplest explanation of the numerical increase of 
enteritidis spores in typhoid diarrhoea is the fact that as a rule all micro-organisms 
normally inhabiting the intestines tend to multiply exceedingly when the character 
ot the bowel contents is modified by disease. So it appears highly probably that 
the increase of enteritidis spores in typical stools is a result, not a cause, of the 
abnormal conditions of the evacuations. 
In conclusion, it is proved that the spores of bacillus enteritidis are constantly 
present, not only in the abnormal evacuations of those suffering from diarrhoea, 
whether it is acute or chronic, mild or severe, arising de novo, or secondary to 
organic disease, but also in the formed evacuations of healthy individuals; conse- 
quently, bacillus enteritidis, frequently of ' normal virulence,' must be regarded as a 
common inhabitant of the human intestine. 
Since writing the above my attention has been drawn to some observations 
by Dr. Hewlett at the Jenner Institute of Preventive Medicine. Adopting Klein's 
method of isolating the spores by heat incubating them anaerobically in recently 
sterilised milk and testing the cultures by inoculation of guinea-pigs, Dr. Hewlett 
sums up his investigations as follows : — 'I have isolated the bacillus enteritidis sporo- 
genes from the dejecta in twelve cases of ulcerative colitis, in one case of ordinary 
diarrhoea, one case of chronic dysentery, and in eleven out of thirteen specimens of 
normal dejecta from ten healthy individuals, and the conclusion I have formed is that 
this organism is probably an inhabitant of the normal digestive tract, and frequently 
to be found in the dejecta.' 
Dr. Legge also examined a number of samples of dejecta from healthy 
individuals ' by means of anaerobic milk cultures and microscopical examinations 
therefrom,' and bacillus enteritidis sporogenes ' seem to be constantly present. 'J 
* Medical Officer's Report, Local Government Board, 1898-99, p. 312-328. 
t Medical Officer' s Report, Local Government Board, 1898-99, p. 312-328 : 
1 Cases 1, 3, 6, 7, 9, 11, 14, 19, 20, 24., 25, 28, 31, 32, 35, 40. 
2 Cases 7, 22, 3 3. 
3 Cases 4, 5, 6, 8, 14, i?, 16, 21. 37, 43, 44. 
4 Cases 3, 11. 
% Transactions of the Jenner Institute of Pre-venti-ve Medicine, second series, p. 73. 
