Bacteriological and clinical studies of the diarrheal diseases of infancy : with reference to the bacillus dysenteriæ (shiga) from the Rockefeller Institute for Medical Research / edited by Simon Flexner and L. Emmett Holt.

Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: Bacteriological and clinical studies of the diarrheal diseases of infancy : with reference to the bacillus dysenteriæ (shiga) from the Rockefeller Institute for Medical Research / edited by Simon Flexner and L. Emmett Holt. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    5 cases both types of the latter organism were present. In view of this finding the appreciation of the extraneous alkali-forming bacillus is of great importance. Single and Double Infection zvith Bacillus Dysenteriae.—We shall for the present denominate as single infection those cases in which a single type, and as double infection those cases in which the two types distinguished as Shiga and Flexner-Harris varieties are found. An examination of the table will show at a glance the great preponderance of the Flexner-Harris type of bacillus in the cases studied by us, which fact is in keeping with Gay and Duval's studies, in regard to types, of the bacilli isolated by Duval and Bassett in 1902. However, 17 of the cases studied in 1903 showed the Shiga type of bacillus. Of these 17 cases the organism was alone present in 11 and associated with the Harris organism in 6 instances. Hence, using our small material of 74 positive cases as a basis of con- clusions, we can say that single infection with the Flexner-Harris type of bacillus is most common, that single infection with the Shiga type of bacillus is far less common, and that double infection with both organisms is least common in the diarrheal diseases of children. Does Any Relation Exist Between the Type of Bacillus and Charac- ter of the Dejecta?—Although it is our experience that the character of the stool is no certain indication of the presence of dysentery ba- cilli in isolatable numbers, yet the stools in which mucus or mucus and blood are present in more than perceptible quantities rarely fail to yield the organism. However, we have failed with a given stool and succeeded with a subsequent one of a like character from the same patient. And while solid or semi-solid fecal material is, as a rule, unpromising, yet in rare instances the dysentery bacillus has been iso- lated from it. Since adult dysentery has, so far as is at present known, been asso- ciated chiefly with the presence of the Shiga type of bacillus, it seemed to us worth while to inquire whether the children in whom that type of bacillus was found presented any peculiarity of infection worthy of notice. Examination of the records of the stools from which the Shiga type of bacilli were obtained has revealed the facts that in 6 instances no blood occurred, in four instances it was present as flecks, and in only one instance in more marked amounts. All the stools, on the other hand, showed mucus, and except in two in- stances in considerable quantities. With one or two exceptions feces were admixed with the mucus. The cases in which double infection occurred were not distinguish-