INFECTIONS OF THE DIGESTIVE TRACT 239 



from the intestine over a long period of time may prove 

 injurious to the cells of the liver and to other cells con- 

 cerned with the pairing of phenol to phenol-sulphuric 

 acid. This deleterious effect is probably of greater 

 importance in persons in whom the cell protoplasm of 

 the liver has been somewhat damaged than in the case 

 of normal persons. 



Skatol. This substance is formed in very small 

 quantities from day to day in some normal persons, and 

 in persons suffering from excessive intestinal putrefac- 

 tion it may be formed in larger quantities than is nor- 

 mally the case. As compared with the quantity of indol 

 found in the intestinal tract, the quantity of skatol is 

 almost always small. I have occasionally met with in- 

 stances in which the f seces contain relatively large quan- 

 tities of skatol, eight to ten milligrams in one hundred 

 grams of fresh material. This has occurred only in 

 persons with marked signs of intestinal or nervous dis- 

 order. Very rarely I have observed much skatol in the 

 intestinal contents with only a mere trace of indol. 1 



Like indol, skatol is derived from tryptophan, but 

 what are the conditions that determine its formation 

 rather than the formation of indol we do not at present 

 know. I have given this subject considerable attention, 

 but without being able to determine the bacteria con- 



1 The most extreme instance of this sort was observed in a 

 patient suffering from multiple neuritis and the psychosis charac- 

 teristic of alcoholic intoxication. As this patient had not taken 

 alcohol, the nervous condition was attributed to an obscure type 

 of intestinal intoxication. A study of the urine and faeces gave 

 some ground for this suspicion. 



