Pub Date : 1931-03-01DOI: 10.7326/0003-4819-4-12-1613_2
B. Ashford
Th e writer first reco gnized the presence of tropical sprue in P orto Rico in the Bummer of 1908 and from that time, for five years, made persist ent effort to connect the clin ical history of the patient "..itl i some definite etiologic agent. In the latter par t of 1913, a yeast found in bread an d in the feces of sprue patients with gaseous d is tension of the intest ine and diarrhea, enhanced by the ingestion of an excess of sweet and cereals, led him to invest igate its pathogenic ity in experimental animals where he discove r ed what he then con sider ed ample reason for incriminating a definite yeast -budding fungus which he n amed Monilia psilosis. The examina t ion of a large number of cases of sp r ue with an equal number of tho se v....ithout this d isease, to determine th e relat ive fr equency of this fungus in t he stools of each of t hese two classes of pat ients, was then pl anned. The series of cases was begun early in 1915, commencing with that of a boy, of six years of age suffer ing from sp r ue in whom the first specific monilia had been r ecognized. 'I'he intention wa to assemble data from a th ousand cases but in experience made this plan too comprehensive. When one r eflects that feces had to be planted in P et r i dishes on solidified glucose agar, suspicious colonies fished. purified by th e Koch three-plate method, examined microscopicall y for morphology, and each pure culture transferred to U-tubes containing a two per cent solution of each of some sixteen sugars, to litmus milk, to gelatin by stab and to a Sabouraud glucose agar 'slant , to be observ ed daily and recorded, it can be seen that a thousand cases would have t aken at leas t five Or six years. The protocol also dem anded that as SOon as th e sugar peptone water fe rmented, it must be tirated by the old ~ sod ium hydrate solution method, In those days pH and the rapid and easy method of watching acid fe rm entat ion by incorporating an in dicator with the original medium was unk nown and fermentation meant , cur rently, the production of gas only. If a yeast failed to produce
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