[Emétine and quinine, a therapy to rescue Bellini in 1835].

At the moment when his operas got a European celebrity, Vincenzo Bellini born in 1801 rapidly died in September 1835 after a three weeks digestive illness, with mainly dysenteria. Young and healthy, this unexpected event questioned the authorities in Paris. The post mortem examination showed that the colonic mucosa was covered by numerous ulcers, and that a large abcess existed in the liver. All other parts of the body were absolutely sound. These results came out from the autopsy performed by Adolphe Dalmas (1799-1844), professor agrégé at the Faculty of medicine of Paris, formerly member of the special committee in charge of fighting the cholera in 1831 and 1832, who studied its medical aspects during the epidemic attack in Russia, Poland, Germany and Great Britain. With a wide knowledge in the field of the intestinal pathology, his conclusions established that the death came from an inflammation of the bowel, excluding clearly any touch of cholera or poisoning. Nowadays, it is obvious that this dysenteria syndome associated to such anatomic disorders would belong to the chronic amebic disease. Probably contaminated in 1828, Bellini developed a severe episode in 1830, necessitating a long rest during several months, spent at Moltrasio along the side of the Lake of Como. At the time, he composed La Sonnambula and Norma. In 1833 after staying in London from April to August, he came to Paris preparing a new work I Puritani (The Puritains). At summer time, he usually suffered slight recurring episodes, that he treated by applying vesicatories. For frequent periods, he lived outside Paris in a villa standing along the Seine in Puteaux rented by his British friends the Levys. Early in September 1835, these symptoms came again and and suddenly worsened with pain, fever and loss of rest at night. Deserted and lonely as the Levys often left the villa, his critical condition exhibiting tremendous sufferings led to death on the 23rd of September. During the final days, he was not granted any relevant medical support, except the poor cares given by the Italian physician Montallegri, not authorised at that time to practice in France. As emetine and quinine since 1822 were both available as pure alcaloids, produced by the pharmacist Joseph Pelletier, it is assumed that Bellini might have recovered after an intensive treatment implementing these substances by oral, local and rectal routes (enemas and suppositories). At that time, apart from the academic teaching inherited from Broussais, the tropical practitioners currently used them in the treatment of dysenteria and tropical liver abcesses (Annesley, Segond and Dutroulau), as decocted ipeca roots and cinchona barks. Later on when the amebic disease has gained its proper nosography, the clinicians underlined the dangerous and unpredictable issues of the hyperacute hepatic syndromes, unexpected and occurring by apparently healthy individuals. By 1960, its treatment was still obtained by the emetine derivatives.