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JAMA. 1970;211(13):2150-2151.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

As defined by Webster, environment is "the aggregate of all the external conditions and influences affecting the life and development of an organism." Environment, according to this definition, is always external. "Internal environment" is a contradiction in terms. Perhaps this is why we prefer the synonymous "milieu interieur," which somehow sounds less paradoxical in French. Pity 'tis we have no similar verbal camouflage for an environment which is neither strictly external nor unequivocally internal—the bacterial flora of the lower gastrointestinal tract.

Inasmuch as the enteric bacteria are invaders from outside the body, they are a part of the external environment—a fact which becomes only too obvious when the ordinarily nonpathogenic microorganisms turn virulent under special circumstances, such as malignancy, debility, or prolonged immunosuppression. On the other hand, the permanence of the bacterial sojourn since birth would favor their inclusion into the internal environment, as would even more strongly their close . . . [Full Text PDF of this Article]

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