The examination of the fecal dejects in the diagnosis of diseases of the rectum is only of value in corroborating the conditions made visible with the aid of our modern instruments for examination of the rectum and sigmoid. Examinations of this character are only of great value to the internist for diseases of the system at large. One is informed, with the aid of the microscope, of the presence of such specific germs in the fecal mass as the amoeba, honeylocust, tubercle or an over-production of the bacillus communist coil The relative value of these examinations for diagnostic purposes varies with the particular field of inquiry. In some cases the information is of no assistance but aids by the elimination of the causes of other possible diseases which manifest similar symptoms, such as might be presented in either typhoid or an ordinary simple catarrh inflammation.

Microscopic Examination of the feces ordinarily reveals the digestive residue germs and other elements gathered as the mass travels through the intestinal tract; or there may be present foreign bodies which have been swallowed in the form of fruit pits, coins, buttons, etc.

The color of the fecal discharge in the healthy adult will vary according to the diet. A diet composed largely of meat, results in a dark brown stool, while a vegetable diet will give a yellowish color. Normally, the reaction is alkaline, but this is dependent upon the character of food eaten and the fluids excreted by the intestinal tract. Children that are fed mostly or altogether upon milk have yellowish or light brown stools.Drugs may affect the colon - calorie producing a greenish stool, rhubarb, Antoninus, or senna producing a tel lowish tint. These medicament will vary the color in accordance with the amount of the drug taken. The quantity of bile secreted will vary the color of the feces to shades of yellow or green.

The Average Evacuation takes place once in every twenty-four hours, but this is not an invariable rule as many persons in perfect health do not evacuate oftener than once in forty-eight hours. In some conditions, due to disease, these intervals vary from four days to a few weeks. In other instances of ulceration or catarrh diseases of the intestine the movements occur as frequently as twenty times in a single day.

Ordinarily the feces of the healthy adult are of a pasty or dough-like consistence, which is molded to the shape of the rectum. Digestive disturbances quickly change the dejection from the usual firm mass of constipation to the characteristic liquid aline discharge of intestinal irritation.

With the aid of the microscope many other constituents may be observed in addition to the color and form. Blood, pus. and mucus in large quantities are easily recognized as such. The seeds of fruit and vegetable matter often appear unchanged. Pieces of vegetables, fruits, nuts and pills may pass through the digestive tract without either proper mastication or digestion.

There may be found gall stones or enteritis from deposits of calcium and magnesium salts around a foreign body as a nucleus. In persons suffering from mucous colitis, mucus may be found in the form of long, structureless, firm, whitish molds of the intestine. When an ulceration exists in the intestine, fragments of the mucosa may often be found in the stools.

The characteristic odor of normal feces is due mostly to the presence of idol, skater. methane and sulphate hydrogen, the result of the digestive process or bacterial action.

Parasites are easily recognized in the stool by the naked eye as they are common constituents of the intestinal canal. Undigested foods as well as material thrown off by the intestinal mucous membrane, stsrch granules, tissue fibers, fat globules, blood corpuscles, micro-organisms and triple phosphate crystals may be seen under the microscope as normal ingredients of the feces.

In pathological conditions, bacteria may be found in enormous numbers, as in typhoid fever, or cholera. In tubercular ulceration of the intestine the tubercle bacilli may be found in the feces.

The microscopical elements of the normal fecal matter consist largely of numerous varieties of bacteria. Most prominent are the bacillus Proteus vulgarism and the bacillus coil communist, none of which appear to be harmful to the healthy intestinal tract. But recent investigation seems to prove that symptoms of auto-intoxication are due to their toxins when the number is greatly in excess of the average, as commonly observed in simple catarrh inflammations of the intestine.

The animal parasites form the most important elements to discover in the examination of feces under the microscope. The amoeba of the protozoa are considered the most important in the causes of intestinal diseases, as so many of these intractable dysentery diseases simulate amebic infection, that it is always a great help in the diagnosis when they are eliminated from the causes. The amebic are often found in the stools of a normal person and may increase in number as the fecal evacuations become more alkaline. They are found imbedded within the mucus or the edges of the characteristic ulcer. The amebic coil cannot be distinguished from the Proteus amoeba so common in water. It consists of a mass of protoplasm without a cell membrane, a nucleus and one or more vacuoles. When examined the stool should be fresh and kept nearly at the body temperature, as the vitality of the amoeba is very little, even at 70° F. Specimens may be kept for further examination if a small quantity of sodium carbonate be added to the mass and then kept at the body heat.

Fatty crystals are abundant in the fecal discharge of nursing infants, in the stools of alcoholics and those suffering from jaundice. Fatty acids and soaps may be seen in large amounts.

The Bacterial Organisms found in the stools of healthy individuals are very numerous and of different varieties, and while in some forms of intestinal disease the bacteria are present in great numbers it would seem, in some instances, that their sole effect upon the body is due to their toxins rather than the direct invasion of the tissue by the living bacteria. It is impossible in most cases to attribute these intestinal diseases to any invasion by a single type or variety of these bacteria. The commonly mentioned bacteria recognized as etiological factors are the streptococcus, staphylococcus, bacillus Pyongyang, lactic iatrogenic and the bacillus coil communist. Other specific bacteria are found associated with diseases of recognized systemic character, such as typhoid fever, Asiatic cholera, diphtheria and tuberculosis. The bacillus oncogenes capsular may also be found in the feces.