AFFECTIONS OF THE VOLUNTARY MUSCLES

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necessary for comfort. One of these, the Chicago, starts onSept. 7th, and on the same day the celebrated first-class

boat La Provence also leaves Havre. What with French

society and French cuisine, it is not surprising if hardly aberth remains vacant on these ships also. A route patroniseelby the Americans, but not well known to the English, is theCyprian Favre line from Marseilles. It has truly been said thatto sail on these ships is more like embarking on a yachtingcruise. Though the fare to and from America costs no morethan the more moderate of the English and German charges,the passenger is entertained on board for nearly twice thelength of time and visits some most interesting countries.He is taken to Naples, Palermo, and sometimes to Almeriain Spain, or he goes to Lisbon and the Azores, all of whichopportunity for sight-seeing is included in the fare to

America. Of this line the -7?oi)ia, which leaves Marseilleson August 27th for Lisbon and the Azores, is due in New

York on Sept. 12th. There are also the Anchor line, the

Red Star line, the Holland America line, the Leland, theDominion, and the American line that have passenger shipssailing in the early part of September, and yet, in spite ofthis extensive choice, it will be found that it is no easymatter to secure a beith at that time of the year, and the

British delegates should be urged to act in this matter

without delay. Many of them have not as yet secured theirberths.

AFFECTIONS OF THE VOLUNTARY MUSCLES.

IT can hardly be denied that in proportion to their bulkand importance in the vital economy the muscles have

received less attention from pathologists than any other

system or organ. Yet undoubtedly in the case of generaldisease they suffer along with all other parts of the body,and some, at all events, of the weakness accompanyingexhausting disorders may be due to actual muscular dis- ’,turbance. It is regrettable that with the exception of a fewrare affections, such as myositis ossificans and polymyositis,little is known of the changes which the muscles undergo,and even in these conditions our knowledge is not at all

conclusive. We welcome, therefore, the paper recentlypublished in the Proceedings of the Neurological Sectionof the Royal Society of Medicine 1 by Dr. R. C. Jewesburyand Dr. W. W. C. Topley, in which are set forth

the results of their investigations into the histologicalchanges met with in voluntary muscle in acute and

chronic diseases. These writers find that in cases

of wasting disease, such as cancer and tuberculosis, micro-scopical examination reveals marked changes in the muscles,the individual fibres varying notably in size and showingincrease in the number of their nuclei. In some instances

these were grouped into darkly staining masses, while inothers they were arranged at the peripheral portions ofswollen fibres, presenting when these were cut transverselythe appearance of multinucleate giant cells. In acute

diseases the muscles may exhibit hyaline or granulardegeneration, but often seem normal. Healthy muscle showslittle interstitial fat, but in diabetes and pancreatic diseasethis substance is increased in amount, as is shown not only bymicroscopical examination but by chemical analysis of the totalfat present. An aggregation of fat droplets around the nucleiof the muscle cells is found in many cases and is scarcelyto be looked on as pathological. True fatty degeneration ofmuscle was found constantly in animals infected with alethal dose of diphtheritic toxin, in which life was prolongedfor more than 24 hours ; it was also found in a human

subject dead of a severe but unclassified form of anasmia,and in a case of infective purpura. Increase in the quantity

1 Proceedings of the Royal Society of Medicine, May 9th, 1912, vol. v.No. 8, June, 1912, Neurological Section, p. 161.

l of glycogen present was seen in the leg muscles in three-

cases in which amputation had been performed for diabetic-gangrene. Amyloid change was never discoverable. In

the discussion which followed the paper Dr. F. W. Mottstated that in general paralysis of the insane-

fatty degeneration of the muscles was found in cases.

in which convulsions had occurred; it was also noted in

persons dead of status epilepticus. He suggested that itwas here due to exaggerated action of the muscles in the-presence of a profound toxæmia.

DEVELOPMENTS IN THE ROYAL SOCIETY OFMEDICINE.

THE Council of the Royal Society of Medicine has takensteps to form Sections of Ophthalmology and Tropical Medi-cine, and it is hoped that both these extensions of the

society’s scientific work will be in working order at the

beginning of the next session. Nothing in the formation ofthese sections will be antagonistic towards the existing’societies for the study of these subjects, whose work will thusbe supplemented, while we may assume that full advantage-will be taken of opportunities for valuable cooperative-debates. The position of the Ophthalmological Society wasexplained in these columns last week. That society proposesto maintain its identity, but views with sympathy the pro-posal of the Royal Society to form an OphthalmologicalSection, and is considering an alteration of its rules to givepractical shape to its support. We understand that in the-

case of Fellows of the Royal Society of Medicine who jointhe new sections within the next six months the admission

fees will be remitted. ____

A NEW VIEW OF THE ORIGIN OF PELLAGRA.

AT first sight it seems extremely unlikely that there can beany connexion between blackbirds and the spread of

pellagra, but the opinion has been recently expressed thatthere is a probability that certain migratory birds, and moreparticularly blackbirds, are acting as reservoirs of the virusof pellagra, and that the actual parasite of the disease willin all probability turn out to be a trypanosome. Dr. M. L.

Ravitch, of Louisville, Kentucky, who has had the assistance-of Dr. Eisenman, the Kentucky State veterinarian, and ofDr, Purdy in his investigations, states that in certain local,areas where pellagra cases have been somewhat numerous, apellagra-like disease has also been found among horses andcattle. Some horses diecl with symptoms similar to thosecaused in South America and other tropical countries bytrypanosoma equinum. These local areas are also said to>

have been infested by migratory birds, more especiallyblackbirds, which arrive in large numbers from the sunnysouth in the spring time and depart in the autumn. It appears-also that Novy and McNeal, in their work on trypanosomes,found these protozoal parasites in the blood of migratorybirds, and among these they placed blackbirds first on the

list. It is admitted that there are difficulties in classifying the-different species of trypanosomes arising from the fact thatthe same species in an animal host often presents manyvarieties, and these in other circumstances would most

probably be regarded as being different species. It is

surmised that mosquitoes or flies may act as transmitters ofthe pellagra virus to man and animals, but whether part ofthe cycle of development of the parasite follows the biting ofthe blackbird by the infected insect is not yet known. Weare told by Dr. Ravitch that in the above-mentioned areas-there has been of late years an unusual plague of flies, andit was observed that where measures were taken to reducethe number of these insects there was less pellagra, -and onthe other hand where these measures were neglected there-were more attacks. The conclusion reached by Dr. Ravitch