Abstract
The development and spread of gas in the soft tissues is usually considered prima facie evidence of anaerobic gas bacillus infection. It is not generally appreciated that colon bacilli either alone or in association with other aerobic bacteria can, in a patient with diabetes mellitus, produce interstitial gas and the severe constitutional symptoms characterizing gas gangrene. Chiari 1 in 1893 reported the first case of the formation of gas due to colon bacillus infection in the tissues of a person with diabetes. After the death of his patient he was able to obtain pure cultures of colon bacillus from all organs, the blood and the soft tissues. Inoculation of animals with the organism failed to produce gas. Chiari therefore expressed the belief that the diabetes favorably conditioned the patient for the production of gas in the soft tissues by the colon bacillus. Hitschmann and Lindenthal 2 in 1899 reported a
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