July 22, 1887.] 



SCIENCE. 



39 



nient from which much advantage was promised and expected, — 

 those of Kremiansl.;! and Bergeon. The former, which was based 

 on the fatal effect of the most dilute solution of aniline on the 

 bacillus, has had but a brief existence, and, so far as we can learn, 

 has been abandoned as being not only of no practical benefit, but 

 as being actually dangerous to life. 



The Bergeon method, on the other hand, seems to promise very 

 much, and, as it is now being extensively employed, its value will 

 doubtless soon be determined. This consists in the introduction 

 into the body of sulphuretted hydrogen and carbonic-acid gas. 

 Lecturing on the subject of tuberculosis at the Hdpital de la Pitie, 

 Paris, M. Debove, in 1883, said the ideal end toward which physi- 

 cians should always strive when in the presence of a parasitic dis- 

 ease, such as phthisis, is to find a parasiticide acting in the interior 

 in the same manner as external remedies act which are employed 

 for the cure of itch. It is necessary to find a substance which, 

 without injuring the system, will be destructive to the parasite. 

 Dr. Bergeon, senior deputy-professor at the School of Medicine at 

 Lyons, suggested the use of hydrogen sulphide, carbon disulphide, 

 and other antiseptic substances, associated with pure carbonic-acid 

 gas, — agents which comply with the requirements of Debove. 



A pamphlet by Dr. V. Morel, published by James \V. Queen & 

 Co., Philadelphia, entitled ' New Treatment of the Affections of 

 the Respiratory Organs and of Blood Poison by Rectal Injections 

 of Gases after the Method of Dr. Bergeon,' contains the experi- 

 mental evidence on which this method is based, together with a 

 description of the apparatus by which it is to be applied. 



The agents by which the bacilli were to be destroyed having been 

 determined, the next step was to devise means for introducing them 

 into the human body without injury. Two methods of introduc- 

 tion presented themselves : the one, by inhalation ; and the other, 

 by introduction into the digestive tube of the same substances in 

 such manner as to be eliminated by the lungs. Dr. Morel states 

 that many inconveniences, grave dangers even, oppose the adoption 

 of the method by inhalation. These antiseptic substances are en- 

 dowed with great toxic power when they penetrate the arterial 

 system, either directly or by way of the lungs, and Claude Bernard 

 has demonstrated that the agents introduced by this method act 

 almost immediately. In addition, they possess a very great local 

 irritation, and this action, exercised on an organ already diseased, 

 cannot but augment the pre-existing lesions. This is, doubtless, 

 the reason that there has been so little success gained in inhalations 

 in the treatment of phthisis, and the disagreeable odor of these 

 substances has contributed to their being refused by the sufferers. 



The introduction of antiseptics by the digestive tube does not 

 offer the same dangers. Bernard has demonstrated that when 

 toxic matter is introduced into an organ removed from the arterial 

 system, — in the digestive tube, for example, — it does not enter 

 into the arterial system, as it is eliminated before penetrating so far. 

 It has then to traverse the portal veins, the liver, the hepatic veins, 

 and the pulmonary tissue. Now, in this course it can be eliminated 

 in the liver by the bile, and in the lungs by exhalation if it is vola- 

 tile. Claude Bernard, after experimentation, stated that hydrogen 

 sulphide can be introduced with impunity into the digestive tube, or 

 into the veins, if care be taken not to give too great quantities at a 

 time. 



The next question to be decided was whether the antiseptic sub- 

 stances should be introduced by the mouth or by the rectum. 

 Inasmuch as they reach the lungs through the same channels by 

 whichever way they are introduced, it would seem to be a matter 

 of indifference which of these two entrances was selected. From 

 a case in which a fatal result followed the introduction by the 

 mouth. Morel thinks that this may indicate that the essential action 

 of the medicament is not the same in both cases. In addition to 

 this, it is important in the adoption of a method of treatment that 

 preference should be given, other things being equal, to that one 

 which is most agreeable to the patient ; and, inasmuch as both the 

 odor and the taste of these antiseptics is very disagreeable, the 

 rectal method is to be selected. By introducing the remedies by 

 the mouth and stomach, we are also in danger of interfering with 

 digestion and alimentation, which are especially important in the 

 ■class of invalids under consideration. For these reasons, Dr. Ber- 

 geon has abandoned the method of injection into the stomach. 



Having adojited the method of rectal injection, it was next neces- 

 sary to find a medicament which would be exhaled by the lungs, 

 and which while in those organs would destroy the tubercles 

 bacilli. 



The first experiments of Dr. Bergeon were made on animals, with 

 chlorine, turpentine, ether, ammonia, and bromine ; but these sub- 

 stances provoked an immediate and violent inflammation of the 

 rectum, and even caused mortification of parts of the mucous mem- 

 brane, and were therefore abandoned. A mixture of carbonic acid 

 and hydrogen sulphide was perfectly tolerable when the two gases 

 were pure and completely deprived of atmospheric air. In their 

 union the carbon dioxide plays in some degree the part of an inert 

 body, attenuating in all cases the irritating properties of the sul- 

 phuretted hydrogen. We know that sulphur possesses germ-de- 

 stroying properties, and nothing is more logical than to apply it to 

 the treatment of pulmonary tuberculosis. The sulphuretted hy- 

 drogen is taken up by the venous system and eliminated by the 

 lungs, — thus this gas seems to fulfil all the requirements. 



The apparatus by means of which these gases are prepared and 

 injected is the invention, or adaptation, of Dr. Morel. It is con- 

 structed on the principle that a current of carbon dioxide passing 

 through, or over, certain gaseous, or volatile, substances will carry 

 with it a certain quantity of these substances : it produces a disas- 

 sociation of the gaseous elements which they hold, and these 

 elements, being liberated, are carried with the current of carbonic- 

 acid gas. It is necessary, first, to produce very pure carbonic-acid 

 gas, and, second, to pass this gas through a liquid medicated with 

 these volatile substances, and to cause it to penetrate the rectum, 

 and to prevent its return to the receptacle for the carbonic acid. 

 The carbonic acid is produced by the action of sulphuric acid on 

 bicarbonate of soda. Hydrochloric acid has been used, but a little 

 always escapes with the carbonic-acid gas, and produces an irrita- 

 tion of the intestine. The carbonic-acid gas as it escapes from the 

 generative flask is collected in a rubber bag. In order to avoid 

 colic, the gas must not contain any atmospheric air. The injection- 

 apparatus consists of the rubber bag filled with carbonic-acid gas ; 

 of a rubber bulb with a valve at each end, to which are adapted 

 rubber tubes, one of which is red and the other black, so as to dis- 

 tinguish the valves ; a metallic T-tube, the vertical branch of which, 

 with a valve at each end, is plunged in the bottle containing the 

 medicated liquid ; and, last, a rubber tube with a pipe on the end 

 for insertion into the rectum. These parts are attached in such 

 manner that the carbonic acid is drawn into the bulb, then forced 

 into the medicated solution in the bottle, taking up the sulphuretted 

 hydrogen, and together these gases are forced into the intestine. 



After describing the apparatus and the method of its use. Dr. 

 Morel calls attention to certain precautions which are to be taken 

 in making the injection. These include the attitude of the patient, 

 the necessity of proceeding with caution, and, at first, its adminis- 

 tration by the physician himself, the time occupied in giving the in- 

 jection, and the amount of gas injected. 



The natural mineral-waters which contain natural sulphuretted 

 hydrogen or sulphides of sodium or calcium have, as a usual thing, 

 been employed by Drs. Bergeon and Morel, being preferred to the 

 artificial waters. The principal springs which contain a sufficient 

 quantity of sulphuretted hydrogen gas or of sulphides for rectal in- 

 jection are AUevard, Aix en Savoie, Eaux-Bonnes, and some fifteen 

 others. To obtain permanent results, the treatment must be con- 

 tinued for months, in order to place the bacilli in a local bath of 

 antiseptic vapors, which at .length will destroy their virulence and 

 power of reproduction. 



The results obtained by Dr. Bergeon in the treatment of consump- 

 tion by his method of rectal injections were communicated to the 

 French Academy of Science in July, 1886, and to the Congress of the 

 French Association for the Advancement of Science, at Nancy, in 

 August of the same year ; and in October the distinguished Profes- 

 sor Cornil made a communication to the Academy of Medicine on 

 the subject. These results of Dr. Bergeon have been confirmed by 

 physicians of Lyons, Paris, Geneva, and Marseilles. These physi- 

 cians have observed the rapid disappearance of the symptoms of 

 pulmonary suppuration in consumptives, and a progress toward a 

 state of health, which has all the characteristics of a complete cure. 

 Dr. Bergeon says that those whom he considers cured do not ex- 



