PRODUCTH OF PUTREFACTION A\D FEIIMENTATIOX 573 



and they are thou combined with sulphuric or glycuronie acid, as 

 follows : 



_ c — ; OH + H : — SO, — OK = < > _ c — o — SO2 — ok 

 N\ ■• ' V_y N\ 



\ CH \ pB. (indican) 



HN -\"H 



B}^ far the greater part of these aromatic substances, when ex- 

 creted in the urine, is combined with sulphuric acid, and but a small 

 part with glycuronie acid ; but in case the amount of sulphuric acid 

 available is too small to combine with all the aromatic radicals enter- 

 ing the blood, a large amount of the glycuronie acid compound ap- 

 pears in the urine (e. g., after therapeutic administration of phenol, 

 cresol, thymol, camphor, etc.)- Both the preliminary oxidation and 

 the combining with acids seem to occur chiefly in the liver, this 

 process constituting one of the most important of the many pro- 

 tective offices of that organ, since the resulting compounds are much 

 less toxic than are the original substances.-^'' Herter and Wakeman -- 

 have shown that living cells have the power of acting upon indole 

 and phenol (and presumably upon the rest of this group) in such a 

 way that they cannot be recovered by distillation. Most active in this 

 respect is the liver, then in order come kidney, muscle, blood, and 

 brain. The change seems to be a loose chemical combination with the 

 protoplasm of the cells, and the power of the tissues to bring about 

 this combination is not greatly, decreased by serious pathological 

 changes in the organs (e. g., ricin poisoning).-^ 



Indole. — This is probably the most important member of this group 

 of substances, the striking color of its derivatives making its detec- 

 tion in the urine easy, so that it is generally used as the most available 

 index of the amount of putrefaction that is occurring in the intes- 

 tines.^* The greatest quantities are found when intestinal putre- 

 faction is marked, especially in intestinal obstruction involving the 

 small intestine ; obstruction of the large intestine, as Jaife first dem- 

 onstrated, does not cause marked indicanuria unless the stagnation 

 involves the ileum, as it may in the latter stages of obstruction. With 

 marked impairment of renal function indican may accumulate in the 

 blood (see Uremia). There can be no question that the indican of the 

 urine is derived, at least in part, from the indole formed in the intes- 

 tine, for administration of indole by mouth to either animals or man 

 causes a considerable increase in the indican present in the urine ; how- 

 ever, but 40 to 60 per cent, can be recovered in this way, the rest ap- 

 parently being oxidized ^0 other compounds, part of which may also 



21a Metchnikoff insisted that these sulfo-compounds still retain considerable 

 toxicity. (Ann. Inst. Pasteur, 1014 (27), 80."^). 



22 .Tour. Exper. :^red.. ISOt) (4), 307. 



23 For further discussion of this topic, see "Chemical Defences against Poisons 

 of Known Composition," Chapter ix. 



24 See Houghton, Amer. Jour. Med. Sci., 1908 (135), 567. 



