INFECTIONS OF THE DIGESTIVE TRACT 281 



proteus organism is a factor. But I am not inclined 

 to ascribe great importance to the proteus organism in 

 this connection, for aerobic liquefiers of gelatin have 

 generally been lacking or few in number. If we assume 

 that the indol produced in these cases of indicanuria is 

 made largely though the action of colon bacilli/ we are 

 brought to the question, In what part of the intestinal 

 tract does the indol production chiefly occur ? We know 

 that the colon bacilli have only a very feeble action upon 

 native proteids such as are used for food. We are there- 

 fore forced to the conclusion that the indol produced by 

 the colon bacilli must have been formed through the 

 cooperative agency of the digestive juices or putrefac- 

 tive bacteria. The anaerobic putrefactive bacteria 

 may be excluded from the present discussion, since the 

 cases here in question are those in which these bacteria 

 are present in only very small numbers in the digestive 

 tract. 2 So we have to fall back on the pro teoly zing action 

 of the digestive juices to explain that preparation of the 

 proteid food which is necessary for a successful attack 

 by organisms of the B. coli type. Where only a moder- 

 ate amount of food is being used, and this in a form 

 readily digested and absorbed, such as egg-white or 

 milk, it is unreasonable to suppose that the foodstuff 



1 1 am confident that an indol-making strain of B. putrificus is 

 sometimes an important agent in establishing indicanuria, but do 

 not know any instance where the influence of colon bacilli could be 

 excluded. 



2 1 have noticed that certain Gram-positive diplococci from the 

 small intestine peptonize casein with moderate rapidity, and it is 

 possible that such organisms, when excessive, prepare the way for 

 the putrefactive action of colon bacilli. 



