SYMPATHETIC GANGLION LESIONS IN SCLERODERMA.

SYMPATHETIC GANGLION LESIONS IN SCLERODERMA.

255 of changes in electrical potential along the of the vessel. By means of high amplification he has been able to demonstrate diphasic followed by mo...

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255 of changes in electrical potential along the of the vessel. By means of high amplification he has been able to demonstrate diphasic followed by monophasic currents in the arteries of animals with each pulse-wave. He has repeated these observations on human subjects with the same results, and claims that these changes are evidence of muscular contraction, since control experiments on dead arteries and elastic tubes were absolutely negative. This work suggests that each pulse-wave is the stimulus to an active contraction of the arterial wall. In veins, also, he found electrical changes, but here of such large amplitude that it was possible to record them without amplification. The feature of these " venous electrograms " is the fact that the " contractions " are wholly irregular and cease after occlusion of the proximal end of the vein. Whatever may be the correct interpretation of these findings they form an interesting contribution to the discussion whether or not an active role should be ascribed to the arteries and veins.

aspect

course

found in a series of controls taken at the same time after death. Other observers have sought in vain for such changes in the nervous system, although symptoms such as facial hemiatrophy and trophoneuroses, and the not-infrequent zonal distribution of sclerodermic plaques, would tend to support the association between scleroderma and lesions in the That Raynaud’s sympathetic nervous system. is to be due to of this system disease syndrome likely would seem to follow from the results of arterial sympathectomy, and the clinical resemblances between scleroderma and Raynaud’s disease in their early stages adds weight to the possibility of a common

aetiology.

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LEGUMINOUS CROPS AND MALARIA.

Prof. Hans Ziemann,! of Berlin, notes that under apparently similar physical conditions, and with similar mosquito prevalence, the amount of malaria may be surprisingly different. D’Herelle informs him that he noticed in the Argentine, 20 years ago, that

grew about the streams and swamps in the malaria-free districts, but not in those where there SYMPATHETIC GANGLION LESIONS IN He observes that malaria disappeared was malaria. SCLERODERMA. from some islands of Holland in 1880, when clover THE aetiology of scleroderma is still much disputed, from the south of France was sown there, and he but facts are accumulating to support the view that agrees with Sir William Willcocks in ascribing the implication of the sympathetic nervous system is freedom of most of Egypt from malaria to the growth associated with, or possibly the cause of, the disease. of wild clover, which is absent in the Suez canal zone, Dr. Geoffrey Blake describes a caseof a woman in Palestine, and in Greece, where the infection is of 30, who had attended hospital in 1919 for symptoms prevalent. D’Herelle ascribes the influence of these pointing to Raynaud’s disease. This is not remarkable, leguminosae to the coumarin contained in their for in the earlier stages of the sclerosing condition blossoms, which appear in the malarial (summer and the extremities are often blue and cold, and the autumn) season. Ziemann also quotes Krysto, of the finger tips and nail beds may present atrophic changes. Russian Agricultural Department, writing in the She was not seen again until 1923, when the skin Scientific American for April, who says that 35 years changes had progressed and were recognised for what ago, when he lived in the Caucasus, everyone in his they really were, scleroderma with some degree of valley had malaria except the four who had planted leukoderma, and the emaciation often associated beans and lucerne around their houses ; he has seen with this condition. There were, in addition, symptoms the same in the Southern States and in Argentina, pointing to spasm of the oesophagus, confirmed by where malaria disappeared when lucerne was sown, X ray examination. In July, 1929, X ray examination though mosquitoes persisted as before. It is suggested revealed obstruction at the pylorus, with dilatation that when the female mosquito sucks juice from these of both the large and small intestines with almost flowers she is either cured of her infection (as a complete obstruction of the descending colon. Ileo- man by quinine), or the gametes are sterilised. and Prof. sigmoidostomy was performed, but diarrhoea and These questions have yet to be studied, a list of some Ziemann calls for He a not and was were experiment. gives relieved, ceecostomy vomiting felt to be imperative. But the symptoms were not 80 coumarin-containing plants and invites people relieved, and the patient died on Sept. 22nd, 1929. living in a malarial district to choose those that will At the autopsy, 12 hours later, sections were made of suit the climate, remembering they must flower the skin and of portions of the endocrine glands. The throughout the worst season of infection. changes due to scleroderma, which had been confirmed by a biopsy of the skin during the patient’s lifetime, were again demonstrated. These included SPEECH AND VOICE.2 loss and atrophy of the papill2e, excessive pigment IN spite of numerous painstaking researches our in the rete, dense sclerotic tissue in the dermis, with of the exact mechanism by which the knowledge secondary atrophy of the cutaneous appendages. sounds of are is still very inexact. speech There were no definite microscopic abnormalities in any Especially is this the produced case for the production of the of the endocrine glands. The whole large intestine showed an abnormal degree of dilatation, which was so vowel-sounds which, although the variations of movement involved are probably very minute, are easily pronounced as to mask hypertrophy of moderate detected by the ear. The differences of voice quality type. Of great interest and importance-especially if a similar problem ; here present quality they are confirmed by reports on other autopsies- and family resemblances are verypersonal definite, so as are the changes described in microscopic sections to be recognised even over the telephone, of the lower cervical sympathetic ganglion. The readily and probably depend on very small differences in the ganglion cells are said to be fewer than normal, many shape and structure of the producing cavities. Sir show striking changes. Some are enlarged and pale and show marked loss of finer structure ; they appear 1 Arch. f. Schiffs- u. Tropen-Hygiene, July, 1931, p. 410. to be "blown up." Others are small and shrunken, 2 Speech and Voice, with X Rays of English, French, German, and stain deeply. Such changes have not been Italian, Spanish, Soprano, Tenor, and Baritone Subjects. of

leguminosae

1 Bull. Johns Hopkins Hosp., April, 1931, pp. 212-227.

Phonetics, Laboratories By G. Oscar Russell, Ph.D., Director and Speech Clinic, Ohio State University. New York : The Macmillan Company. 1931. Pp. 250. 17s.