The Elimination of Indoxyl Sulphate in the Urine of the Insane. by J. Harvey

An excessive production of indol in the intestine, manifested by increased elimination of indoxyi sulphate or indican in the urine occurs in a number of diseases. The causation of functional nervous disorders among others has been ascribed more than once to indol poisoning, and it is a fact of every-day laboratory observation that the urine of those suffering from migraine or “the blues” and that of persons even mildly neurasthenical frequently give, with the usual tests, a marked reaction for indoxyl. Herterr discussed the question of the occurrence of indican and the paired sulphates in idiopathic epilepsy and concluded that attacks of convulsions were sometimes precipitated by an increase in intestinal putrefaction marked by an excess of indoxyl and other ethereal sulphates in the urine, and that these factors were most active in those who suffered from chronic intestinal catarrh, and generally occurred after excesses in eating. Under these conditions, he obtained by oxidation as high as 82 milligrams of indigo blue, determined gravimetrically, from the daily urine of a patient. The amount of indoxyl excreted varied widely, and might in the same subject be large one day and a bare trace the next. Richardson’ believed indol to be excessive in most forms of mental disease, and submitted a chart, including nearly all the functional insanities as well as some having an anatomical basis which tended to demonstrate this. He estimated indol by