The Relation of Types of Diarrhœa in Children to Strains of Bacillus Dysenteriæ

The association of the dysentery bacillus with diarrhoea in infants is now established. Previous studies on the subject from this laboratory having proven this occurrence, we undertook as our present thesis the separation from the dejecta of all bacteria which could be cultivated, and which agglutiinated with the patient's blood, exhibited pathogenic properties for laboratory animals, or belonged to the so-called dysentery group of bacilli. A part of our problem, to which we gave particular attention, was the determination of the special type, strain, or variety of dysentery bacilli occurring in the different classes of cases of diarrhoea, and the frequency with which these strains were found associated with the cases. The entire number of infants studied was seventy-four. They could be divided clinically into the several groups which follow with the number of cases of each group studied. Inflammatory colitis,--29 cases. Toxic, dyspeptic, or fermental diarrhoea,--36 cases. Intestinal indigestion,-7 cases. Chronic gastro-enteritis,--~ case. Tuberculous ileo-colitis,--i case. In twenty of the cases malnutrition was a marked feature. I t was thought unwise to at tempt further to subdivide the cases. I t is doubtful if our series included any of the nervous diarrhoeas given in the classification suggested by Dunn. 2 The result of t reatment was as follows: Thirty children recovered completely, twelve improved, one was unimproved, and thirty-one died.