Abstract
The duodenal tube was sterilized by boiling in water for ten minutes and the lower end was covered with a tightly-fitting gelatin capsule which had been soaked in alcohol for several days. The gelatin capsule was finally coated with shellac and dried. The tube was ordinarily given late at night and the sample of fluid aspirated on the following morning, usually without any food being taken in the interval. In a few cases the fluid was obtained an hour after giving an Ewald test meal.
The study of the fluid included inspection, direct microscopic count of the bacterial cells, plating of measured amounts on litmus lactose agar and ascitic-fluid agar, separation cultures of measured quantities in tall tubes of ascitic-fluid agar and fermentation-tube cultures of measured quantities in dextrose broth and lactose broth. In addition, a portion of the fluid was heated to 80° C. for ten minutes and inoculated in measured quantities into tall tubes of glucose ascitic-fluid agar and into fermentation tubes of glucose broth and lactose broth.
Thirty-five samples were studied, of which the first nine were unsatisfactory because of defects in technic. The results obtained on the remaining twenty-six serve as a basis for this report.
The results can be presented here only in summary form. In general, the number of bacterial cells seen microscopically varied from 600,000 to 960,000,000 per C.C. and their number bore no evident relation to the number of colonies obtained in cultures nor to the clinical condition of the patient. On the other hand, the results of the culture work indicate that the normal duodenal fluid is practically free from living bacteria when food is absent, and that the number of cultivable bacteria obtained in a given case is a rough index of the digestive derangement.
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