268 INFECTIONS OF THE DIGESTIVE TRACT 



shows plainly that in the treatment of indicanuria one 

 has to consider not only the proteid food which is given, 

 but also the carbohydrates. With many persons the 

 excessive use of carbohydrates is habitual and the sub- 

 stitution of small quantities of quickly digested carbo- 

 hydrates like rice for large quantities of bread or sugars 

 may make a considerable difference in the amount of 

 indican excreted. Diastatic enzymes can be made to 

 render good service in this connection. Assuming that 

 the persistent indicanuria in the cases in question is due 

 at least in part to the upward extension of colon bacilli 

 and certain putrefactive anaerobes into the small 

 intestine, it seems reasonable to believe that the with- 

 drawal of excessive carbohydrates is equivalent to a 

 diminution in the pabulum on which the microorganisms 

 multiply so readily with the production pf gas and acid 

 and indol. 



As will be seen in speaking of the treatment of chronic 

 excessive intestinal putrefaction, the use of cathartic 

 medication is usually followed very promptly by a 

 diminished absorption of indol from the intestine. 

 Persons suffering from great indicanuria are apt to show 

 a marked diminution in the excretion of indican after the 

 administration of calomel or cascara or a saline or other 

 cathartic. The indican may in rare instances entirely 

 disappear temporarily. This effect is, however, only 

 of very short duration. The diminished excretion of 

 indican is due of course to the mechanical removal of 

 indol-forming and indol-containing contents of the 

 intestine. A diminished absorption of indol is associated 



