280 INFECTIONS OF THE DIGESTIVE TRACT 



I. THE INDOLIC TYPE OF EXCESSIVE INTESTINAL 

 PUTREFACTION 



It has already been stated that there is some reason 

 for believing that organisms of the B. coli type which 

 are capable of forming indol abundantly may invade the 

 small intestine and there give rise to bacterial cleavages 

 which largely replace the normal try p tic digestion. The 

 proof that the small intestine is invaded by some variety 

 of indol-producing colon bacilli in cases of marked indi- 

 canuria is still lacking, for the reason that it is ordinarily 

 impossible to obtain evidence on this point from a living 

 subject, whereas postmortem studies with reference to 

 this point are open to criticism on account of the rapid 

 wandering of the colon bacilli which occurs after death. 

 Of all the organisms of the digestive tract which we have 

 individually studied, we have found none that will make 

 a larger amount of indol than certain strains of colon 

 bacilli when grown on peptone bouillon. There are, 

 moreover, cases of excessive intestinal putrefaction in 

 which the dominant organism in the intestinal tract (if 

 we may judge from the material obtained through the 

 use of cathartics) is some variety of colon bacilli. In such 

 cases, the anaerobes of the intestine may be present in 

 very small numbers, so that it seems safe to exclude 

 them from a significant part hi the formation of putre- 

 factive products. It seems reasonable hi these cases 

 to attribute the formation of indol to an unusual activity 

 on the part of the colon bacilli. There are, perhaps, also 

 instances in which the presence of an indol-producing 



