40 



SCIENCE. 



[Vol. X. No. 233 



pectorate, or offer to auscultation any stethoscopic signs but those 

 of dr}'ness due to the presence of cavities which have cicatrized, or 

 are in process of cicatrization, or to cicatricial bands consecutive to 

 old lesions. Some of these patients have been obliged to take up 

 again a ver)' laborious existence. Mounting a great many stairs 

 many times in the course of the day, nevertheless, their respiratory 

 organs have resisted all these fatigues, and the improvement gained 

 has been steadily maintained. In most of the patients, in two or 

 three days, there is a marked diminution of the cough, the expecto- 

 ration, the night-sweats, and the difficulty in respiration, which 

 accompany pulmonary phthisis ; in time, the patients gain a feeling 

 of health and an increase in strength. Little by little the favorable 

 symptoms gain the advantage, and the patients cease to lose flesh, 

 and commence to gain it. 



Dr. Morel notes the remarkable fact, that, even in patients who 

 are apparently restored to health, the tubercle bacilli are still 

 present in the sputum, and says that it remains to be ascertained if 

 the bacilli which persist in the sputum, notwithstanding the return 

 of health, still possess their functional activity, that is, the property 

 of developing to any great extent, to infiltrate anew the pulmonary 

 tissue, and there produce lesions similar to those which have been 

 cured by the administrations of medicated gaseous rectal-injections. 

 The constant presence of the bacilli in the sputum, after health has 

 been restored, indicates two things; first, that their hurtful action 

 is neutralized for a long time by the medication, and, second, that 

 as long as they remain in the sputum, a return of the malady is to 

 be feared, and on this account the injections should not be aban- 

 doned, even though it appears that the cure is complete. Many per- 

 sons who have been so improved after several weeks of treatment 

 as to consider themselves cured, have discontinued the injections, 

 and have suffered a relapse. 



Dr. Morel states that it is not the bacilli which are to be feared 

 in phthisis, but the septicsemia caused by their presence in the pul- 

 monary cavities, this being due to the absorption of the infectious 

 products of .the bacilli. The elimination of the medical principle in 

 the gaseous injections by the alveolar and bronchial surfaces of the 

 lung combats victoriously this septicasmia. While this elimina- 

 tion is -taking place, these infectious products are neutralized, or 

 better, are not absorbed. When the pulmonary lesions are com- 

 pletely healed the injections must be discontinued, because, the 

 bacilli being no longer in contact with a diseased surface, there is 

 no fear of septicsemia. But if the injections are stopped before the 

 walls of the cavities are entirely cicatrized, or if the cicatrization is 

 not rendered permanent by prolonged treatment, the cicatrized part 

 will ulcerate anew, and by the contact of the bacilli the septicemia 

 is renewed. It is then necessary, in order to prevent the return of 

 the malady, to take the injection time after time, even when the 

 state of the health is satisfactory, and, with still greater reason, if 

 the old symptoms, cough, expectoration, fever, and emaciation re- 

 appear. 



It has also been noted that the improvement is not confined to 

 the lung-lesions. When tubercular ulcerations of the larynx and 

 pharynx exist, these are also cured without any further applications, 

 solely by the contact of the gases as they are exhaled from 

 the lungs. 



Dr. Chantemesse, chief of the laboratory of bacteriology of the 

 faculty of medicine, Paris, and physician of the hospitals, reports 

 nine patients in his practice who had presented both the local and 

 general symptoms of pulmonary tuberculosis, with the presence of 

 bacilli in the expectorations, as having undergone great improve- 

 ment under Bergeon's treatment ; the increase in weight was rapid, 

 sometimes a kilogram a week, while the cough and the expectora- 

 tion were considerably diminished. The bacilli remained constant 

 in the sputum. Professor Cornil is now engaged in experimenting 

 upon tuberculous animals. He says that the rectal injection of 

 carbonic-acid gas and of sulphuretted hydrogen constitutes an ex- 

 cellent therapeutic method in phthisis, and should gain more favor, 

 in view of the fact that therapeutics are powerless in the face of 

 phthisis. In this disease the only agents which till now have been 

 found useful are foods and those remedies which aid nutrition. Dr. 

 Morel claims that this method of treatment is not confined to 

 tuberculosis. He claims much benefit from it in whooping-cough, 

 bronchitis, and in the infectious diseases, such as typhoid-fever, the 



eruptive fevers, and septicaemia, in which blood poisonir^g results from 

 the introduction into the blood of infectious products of microbes. 

 The infectious elements, spread throughout the blood, come in 

 contact with the medicated gas, not only in the lungs, as in tuber- 

 culosis, but also in the right heart at the moment when the 

 blood of the two venae cavae is united, and in all its course through 

 the branches of the pulmonary artery. The venous blood, thus 

 purified, frees itself of the excremental products on its arrival at the 

 pulmonary cells, and re-enters, disinfected, the branches of the pul- 

 monary veins. Thus is explained the diminution of fever and the 

 amelioration of the disease which occur in the cases where gaseous 

 injections are employed. 



Drs. Spillman and Parisat have made experiments to determine 

 to what height intestinal distension reaches after injecting eight 

 pints of gas, and find that in the cadaver the large intestines only 

 are distended. They find it impracticable to use a larger amount in 

 the living subject on account of cramps and the danger of produ- 

 cing paralysis of the intestines. They conclude, from their experi- 

 ments, that the method of Dr. Bergeon is powerless in averting 

 tuberculous exacerbations ; much less is it capable of arresting the 

 development of phthisis. The night-sweats do not seem to have 

 been influenced by the medication, and the temperature was not 

 permanently lowered. The appetite was not disturbed, but there 

 was temporary intestinal uneasiness, with distension of the ab- 

 domen, rendering confinement to the bed necessary. The weight 

 remained the same ; sleep was quiet and restful, due solely to- 

 the carbonic-acid gas. According to these writers, rectal gaseous- 

 medication is palliative, not curative. 



In England, the method has been employed by Dr. Bennett, 

 and by Dr. Heron at the Victoria Park Chest Hospital. The 

 London Lancet, in commenting on the method, says that the evi- 

 dence is forthcoming that the treatment has been followed by many 

 signs of improvement in at least some of the patients, and urges 

 a more extended trial. The writer in that journal does not think it 

 necessary to suppose that the gas must act after the fashion of a 

 true germicide or antiseptic, but it may be that the value of the 

 treatment, supposing it to have any, consists in improving the 

 nutritive powers of the tissues, in increasing their vitality, thereby 

 rendering them more able to cope with deleterious influences, or 

 with the germs, by affording an unsuitable soil for the activity of 

 the latter. 



In our own country, much has already been done in testing this 

 new plan of treatment. Dr. Crane of Chicago has used it in four 

 cases, two of phthisis, one of intussusception of the bowel, and one 

 of spasmodic croup. With the latter cases it acted like a charm, 

 overcoming both almost instantly. In the case of croup, carbon bi- 

 sulphide was used instead of sulphuretted hydrogen- One of the 

 phthisis cases was a man, aged twenty-six years, whose two sisters 

 and brother had died from that disease, and who had been under 

 treatment for three years, during which time he had been twice to- 

 Colorado. Under the sulphuretted hydrogen he improved very- 

 fast, in one week his temperature becoming normal, the night-sweats 

 almost stopped, and the expectoration became less. In the latter 

 part of the second week of treatment he ventured out on a rainy 

 March day, took cold, and died in two days. The second case was 

 that of a widow, aged twenty-four years, whose mother and sister 

 died from phthisis. She was suffering from incipient phthisis. 

 She made seven visits to Dr. Crane, and then pronounced herself 

 cured. The doctor thinks that she will probably have a return of 

 her symptoms upon the slightest provocation. He has tried the 

 mineral waters of Lafayette, Ind., Blue Lick, Ky., and Ypsilanti, 

 Mich., and considers the last best adapted for the purpose. It is 

 so strongly impregnated with gas that he is able to use it a second 

 time. He has devised an apparatus for the manufacture and injec- 

 tion of the gas, differing from Morel's in no important particular, 

 save in the expense of manufacture, which is reduced about one- 

 half. 



Dr. M. M. Johnson, of Hartford, Conn., has been using Bergeon's 

 method in the Hartford dispensary for two months. The patients 

 are mostly those in advanced stages of phthisis. The night-sweats 

 have ceased, the cough has become loose and expectoration easy, 

 the patients sleep well and have increased in weight, the circulatiort 

 is quickened, and the cold, clammy extremities have become warm. 



