not, in short, until the inoculated bacteria have had time enough to grow in the body and produce the poison in quantity.  It has not by any means been shown that all pathogenic germs produce their effect in this way, but it has been proved to be the real method in quite a number of cases, and is extremely probable in others.  While some bacteria perhaps produce results by a different method, we must recognise the production of poisons as at all events the common direct cause of the symptoms of disease.  This explanation will enable us more clearly to understand the relation of different bacteria to disease.

PATHOGENIC GERMS WHICH ARE NOT STRICTLY PARASITIC

Recognising that bacteria may produce poisons, we readily see that it is not always necessary that they should be parasites in order to produce trouble.  In their ordinary growth in Nature such bacteria will produce no trouble The poisons will be produced in decaying material but will seldom be taken into the human body.  These poisons, produced in the first stages of putrefaction, are oxidized by further stages of decomposition into harmless products.  But should it happen that some of these bacteria obtained a chance to grow vigorously for a while in organic products that are subsequently swallowed as man’s food, it is plain that evil results might follow.  If such food is swallowed by man after the bacteria have produced their poisonous bodies, it will tend to produce an immediate poisoning of his system.  The effect may be sudden and severe if considerable quantity of the poisonous material is swallowed, or slight but protracted if small quantities are repeatedly consumed in food.  Such instances are not uncommon.  Well-known examples are cases of ice-cream poisoning, poisoning from eating cheese or from drinking milk, or in not a few instances from eating fish or meats within which bacteria have had opportunity for growth.  In all these cases the poison is swallowed in quantity sufficient to give rise quickly to severe symptoms, sometimes resulting fatally, and at other times passing off as soon as the body succeeds in throwing off the poisons.  In other cases still, however, the amount of poison swallowed may be very slight, too slight to produce much effect unless the same be consumed repeatedly.  All such trouble may be attributed to fermented or partly decayed food.  It is difficult to distinguish such instances from others produced in a slightly different way, as follows: 

It may happen that the bacteria which grow in food products continue to grow in the food even after it is swallowed and has passed into the stomach or intestines.  This appears particularly true of milk bacteria.  Under these conditions the bacteria are not in any proper sense parasitic, since they are simply living in and feeding upon the same food which they consume outside the body, and are not feeding upon the tissues of man.  The poisons which they produce will continue