266 INFECTIONS OF THE DIGESTIVE TRACT 



reduction in the output of indican. The improvement 

 is probably due to the more ready digestion and absorp- 

 tion of the milk. But there are instances in which the 

 substitution of milk for meat does not materially influence 

 the output of indican as judged by the Obermeyer 

 reaction. The invasion of the small intestine by colon 

 bacilli (and perhaps putrefactive anaerobes) would 

 satisfactorily explain this phenomenon, since in such a 

 case even the more rapid absorption incidental to a 

 milk as compared with a meat diet would not suffice to 

 elude the action of the colon bacilli upon peptones formed 

 in the course of digestion. There are also cases in which 

 no dietetic measures have a marked influence in reducing 

 the excretion of indican. That is to say, the indicanuria 

 remains well marked whether proteid food be employed 

 in the form of meat or milk or eggs or cereals. Dr. George 

 A. Tuttle of the Presbyterian Hospital has made the 

 observation that there are cases of indicanuria which 

 though persisting on a milk diet are susceptible of 

 striking improvement or complete disappearance through 

 the agency of potassium iodide. The cases of this type 

 have always been cases of marked arterial sclerosis 

 and some of them have had a history of syphilitic 

 infection. The explanation of this noteworthy fact 

 is obscure. The possibility occurs to one that the 

 potassium iodide influences favorably the circulation in 

 the intestine and this aids rapid absorption, but it is 

 also possible that the iodide may hi some way increase 

 the oxidizing activity of the cells mainly concerned with 

 the composition of indol in the body, notably the 



