Physiology. — ‘Concerning Sulphaemoglobinaemia.” By Prof. A. A. 
HiJMANS VAN DEN BERGH. 
(Communicated at the meeting of March 26, 1921). 
The blue colour of the skin and the mucous membranes, called 
cyanosis is almost exclusively due to a lowered oxygen, content 
of the blood. Occasionally it is brought about by a slight 
modification of the blood-pigment into the so-called methaemoglobin, 
consequent on poisoning with some substances, such as_ nitrites, 
nitrobenzol, anilin-derivatives and the like. We are greatly indebted 
to Srokvis and to Tatma') for pointing out to us the fact that 
in some cases of intestinal disease poisonous substances formed 
in the intestinal canal are resorbed in the blood, and likewise evoke 
methaemoglobinaemia with cyanosis. My own researches made in 
19057) went to show that in these forms of enterogenous methae- 
moglobinaemia nitrites are answerable for the formation of methae- 
moglobin from the bloodpigment. In addition, on further investigation 
I came across people exhibiting such a cyanosis, which, however, 
appeared not to be due to the presence of methaemoglobin but to 
a substance that possessed qualities which proved it to be sulphae- 
moglobin i.e. the compound formed when allowing small quanta 
of sulphuretted hydrogen to act upon haemoglobin. In all these cases 
the serum was free from dissolved pigment, so that there was no 
haemolysis. Afterwards we met with another form of methaemo- 
and sulphaemoglobinaemia®), this time attended ‘with marked haemo- 
lysis and most likely caused by anaerobe bacteria. So we know 
already three forms of this cyanosis: the septic sulphaemoglobinaemia 
with haemolysis; the intraglobular methaemoglobinaemia; and the 
intraglobular sulphaemoglobinaemia. We now intend to record some 
new researches concerning the intraglobular sulphaemoglobinaemia. 
Our own observations together with those of various English physici- 
1) Sroxvis, Festschr. f. Leyden, en Ned. Tijdschr. v. Geneesk. 1902, Il, 678. 
TALMA, Ned. Tijdschr. v. Geneesk., 1902, II, 721. 
2) HijMANs v. D. Ber@H, Deutsch. Arch. f. klin. Mediz. 1905, LX XXIII, 86. 
HiyMANS v. D. BERGH en GRUTTERINK, Berlin. klin. Woch. 1906, I. 
5) HijMmANs v. D. BERGH, Ned Tijdschr. v. Geneesk. 1918, I. 1774. 
