508 VICTOK C. MYEKS 



With regard to the elimination of fecal nitrogen under pathological 

 conditions, observations show that it is increased in biliary obstruction, 

 intestinal fermentative dyspepsia, and diarrhea ; and decreased in chronic 

 constipation. 



A great variety of substances may be formed by bacterial action upon 

 protein or its cleavage products. Among such may be mentioned indol, 

 skatol, phenol, indol acetic acid, various oxyacids, in certain instances, 

 putrescin and cadaverin, etc. That intoxication may result from poisonous 

 products formed by bacterial action can hardly be questioned, though 

 just what the substances are that exert this action cannot be stated at 

 the present time. Much attention has been devoted to the products of 

 bacterial action on tryptophan, viz., indol acetic acid (urorosein of 

 urine), skatol and indol. Myers and Fine found comparatively large 

 amounts of skatol and indol in the stools of pellagra patients. In many 

 of the patients the stools were rather soft. Ordinarily skatol appears 

 to be observed in the feces much less frequently than indol,. but the reverse 

 was true in these cases. In the case showing the most severe putrefaction, 

 the skatol of the feces averaged 51 nag. and the indol 21 mg. per day. 

 The indican of the urine was much lower in this case than in several other 

 subjects who excreted much smaller amounts of skatol and indol in the 

 feces. It seems questionable whether the skatol and indol in the amounts 

 absorbed in this way have any toxic properties. The presence of large 

 amounts of indican in the urine, however, is excellent evidence of in- 

 creased intestinal putrefaction. 



Ethereal Extract. The bodies which go to make up this ethereal 

 extract are the neutral fats, free fatty acids (and fatty acids in the form 

 of soaps when an acidified solvent has been employed), and coprosterol 

 (stercorin of Flint) formed from cholesterol by the action of reducing 

 bacteria. Myers and Wardell found the coprosterol (and cholesterol) of 

 dry feces to vary between 0.5 and 1.5 per cent, the high figures being 

 found in soft stools. The ethereal extract ordinarily forms from 12 to 

 25 per cent of the dry weight of the feces. The utilization of fat varies 

 under normal conditions from 90 to 05 per cent, depending upon the 

 source of food. The higher fats such as stearin are much less readily 

 assimilated. In biliary obstruction as much as 70 grams of fat may be 

 eliminated in the feces, forming 50 per cent of the dry weight of the 

 material. In various conditions associated with defective fat digestion 

 (pancreatic disease) or defective fat absorption increased amounts may 

 be eliminated, while in chronic constipation the amount may .be decreased. 

 In both biliary obstruction and pancreatic disease the fat utilization has 

 Veen found to be as low as 25 per cent. 



Carbohydrate Residues. Normally feces may yield on hydrolysis 

 reducing substances equivalent to from one-half to two grams of glucose 

 or from two to six per cent of the dry weight of the feces. Although the 



