236 INFECTIONS OF THE DIGESTIVE TRACT 



The clinical conditions present in one of Van der 

 Bergh's cases of enterogenic cyanosis deserve mention. 

 This case was a child nine years of age in which there were 

 marked digestive disturbances with diarrhoea. It had 

 been observed by the mother that the child passed very 

 little urine. This anuria was probably owing to the 

 constant diarrhoea. For two years the mother had ob- 

 served that her child readily became bluish on slight 

 excitement. This condition gradually became more 

 pronounced, and finally the child grew very cyanotic 

 even when at rest. The ends of the fingers were also 

 somewhat clubbed. When the child was three or four 

 years of age the abdomen became much distended and 

 this distension gradually increased. There was no evi- 

 dence whatever of any cardiac affection. The urine was 

 very much reduced in amount and contained no albumin 

 and no sugar, but is said to have contained a little indol. 

 The sediment contained many bacteria, leucocytes, and 

 calcium oxylate. The movements were very thin, had 

 a strongly alkaline reaction, and smelled of ammonia. 

 The movements were sometimes yellow, sometimes dark 

 brown or nearly black, and always became very dark on 

 standing in the air. No protozoa were found. The 

 author states that a fistula existed between the bladder 

 and rectum, and this was probably the cause of the indol 

 found in the urine. The child was not anaemic. An 

 endeavor was made to control the cystitis by means of 

 urotropin and the proteid food was greatly reduced in 

 order to diminish the hydrogen sulphide formed in the 

 intestine. This resulted in the disappearance of indol 



