INFECTIONS OF THE DIGESTIVE TRACT 235 



moglobin observed in his cases was the result of intoxi- 

 cation through the intestinal tract, due to poisonous 

 substances formed there. In 1905 Hi j mans van der 

 Bergh l reported two cases of enterogenic cyanosis which 

 at first sight appeared to have the same pathological 

 basis as those reported by Stokvis and Talma. He found, 

 however, on careful investigation that the substance 

 contained in the blood of one of his patients could not 

 have been methaemoglobin. 2 The absorption spectra 

 observed by him showed the closest similarity to the 

 spectrum of sulphhsemoglobin. Attempts were made to 

 determine the presence of hydrogen sulphide or rather 

 of sulphhsemoglobin in the blood, but these were not 

 wholly successful, although he was able by means of the 

 Caro-Fischer reagent (a solution of pure amidodimeth- 

 ylanilin with ferric chloride) to obtain a blue color 

 due to the formation of methylene blue and indicative 

 of the presence of hydrogen sulphide. Van der Bergh 

 concludes that his patient suffered from the passage of 

 hydrogen sulphide into the blood from the intestine. 3 



lf 'Enterogene Cyanose," Deutsch. Archive /. Tdin. Med., 

 Ixxxiii, p. 86, 1905. 



2 This writer has lately reported one instance of enterogenic 

 cyanosis associated with methaemoglobinsemia, in which the blood 

 was shown to contain nitrites. This observation appears of 

 much importance for the doctrine of intestinal intoxication, as it 

 is well established that nitrites readily cause methaemoglobinsemia 

 under experimental conditions. A. A. Hymans van der Bergh 

 und A. Grutterink, " Enterogene Cyanose," Zweite Mittheilung, 

 Berl. klin. Wochenschr., No. 1, p. 7, 1906. 



3 Several of these cases of sulphhsemoglobinsemia have been 

 associated with obstinate constipation, the relief of which has been 

 followed by rapid improvement in the blood state. 



