INFECTIONS OF THE DIGESTIVE TRACT 267 



liver cells. 1 The increased oxidation of indol would 

 lead to a diminished excretion of indican and perhaps 

 to its complete disappearance. Dr. Tuttle tells me also 

 that he has had patients in whom the administration of 

 iron in the form of Basham's mixture has soon been 

 followed by a marked lessening of the indicanuria. As 

 this has occurred in cases where the diet has been care- 

 fully studied and dietetic measures have failed to give 

 the desired relief, Dr. Tuttle has attributed the thera- 

 peutic action to the iron. 



It is worth noting that wherever there is a persistent 

 indicanuria which has not yielded to a change in the 

 character of the proteid food nor to a diminution of it 

 nor to a restriction of the carbohydrates, one may 

 rationally employ gelatin as a nitrogenous substance 

 capable of replacing in some degree the proteids of the 

 diet. Gelatin does not contain a tryptophan nucleus 

 and hence cannot yield indol. It has been shown by 

 physiologists that the metabolic needs of the organism 

 for nitrogen may be in part met by the use of gelatin, 

 although as is well known gelatin alone is incapable 

 of maintaining the protoplasm of cells where proteids 

 are wholly withdrawn from the dietary. I consider it 

 entirely safe to replace a portion of the nitrogen of the 

 food by gelatin (in the form of jellies) and believe I 

 have observed a falling off in the indican of the urine in 

 consequence of this substitution. Clinically, experience 



1 The presence of iodides in a urine containing indican inter- 

 feres with the Obermeyer reaction, but this source of error appears 

 to have been eliminated in the procedure followed by Dr. Tuttle. 



