234 INFECTIONS OF THE DIGESTIVE TRACT 



Hydrogen Sulphide and its Relation to Enterogenic 

 Cyanosis. In 1902 Stokvis 1 described a peculiar and 

 apparently new clinical state under the name of " auto- 

 toxic enterogenic cyanosis." His observation had refer- 

 ence to a man fifty-eight years of age who suffered from 

 a severe enteritis associated with pronounced cyanosis 

 of the skin and visible mucous membranes, together with 

 a slight swelling of the terminal phalanges. On making 

 a spectroscopic examination of the skin and mucous 

 membranes of his patient, Stokvis was easily able to 

 make out in addition to the two feeble oxyhsemoglobin 

 bands a small absorption band in the red, corresponding 

 to the absorption spectrum of methsemoglobin. It is 

 of course well known that the experimental methse- 

 moglobinuria which may be induced by a variety of 

 poisons, such as potassium chlorate, nitrobenzol, and 

 various derivatives of anilin, gives rise to a characteristic 

 cyanosis of the skin and mucous membranes. Stokvis 

 was therefore inclined to believe that the cyanotic 

 discoloration of the skin of his patient could be ascribed 

 to the methsemoglobin present in the blood. He assumed 

 that some poisonous substances had been formed in the 

 intestine which gave rise to a transformation of a portion 

 of the haemoglobin into methsemoglobin. Three similar 

 cases were soon after reported by Talma, 2 who reached 

 the same conclusions as Stokvis ; namely, that the methse- 



1 " Zur Casuistik der autotoxischen enterogenen Cyanosen 

 .(Methaemoglobinaemia (?) et enteritis parasitaria)," Festschr. f. v. 

 Leyden, i, p. 597, 1902. 



2 Tijdschrift voor Geneesk., ii, p. 721, 1902. 



