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COMPLAINTS OF THE DIGESTIVE TRACT. ,301

" In diseases of the stomach, which lead either to an insuffi-
cient acidification or an abnormally long retention of the food
in the stomach, fermentative decomposition of the ingesta readily
takes place. In such cases the carbohydrates are decomposed
partly into gaseous products, and, according to the ferments
present, sometimes the alcoholic or acetic acid fermentation and
sometimes the lactic or butyric acid fermentation will ensue.
" My colleague (Rupstein) and myself had opportunity to watch
a case in which, as the patient very drastically expressed himself,
the vinegar factory alternated with the gas factory. In one case
the alcoholic fermentation led to the formation of acetic acid,
then tlie butyric acid fermentation to the evolution of hydrogen
and carbonic acid. This case was especialh' remarkable for the
fact that the patient occasionally belched up higher compounds of
carbon and hydrogen, such as marsh-gas and possibly olefiant gas,
which, on holding a candle to his mouth, ignited and Inirned with
a weak flame."
Escherich,^^* whose examinations into the diseases of the sto-
mach and intestines of infants are probably known to the reader,
also recognizes the important part played by bacteria in these
diseases, and recommends, besides the administration of antisep-
tics, as still more important than these, a strict regulation of diet.
It would, however, lead us too far to notice the difl:erent
views concerning the importance of gastric fermentation for the
origin of catarrhs of the stomach, dilatations, etc. The oliserva-
tious of thousands of physicians sufficiently prove the occurrence
of abnormal fermentative processes in the stomach ; and no one
can deny that such processes may appear in stomachs whose
functions are otherwise normal as well as in diseased ones. The
greater the mechanical or chemical insufficiency, the more
violent will be the fermentative processes and the more injurious
their action on the digestion.
According to Minkowski,^-^^ the disturbances which are directly
caused by the fermentative processes in the stomach may be
referred to the following factors :
1. Substances may be formed which irritate the mucous mem-
brane of the stomach and bring about a state of catarrhal inflam-
mation.