1
251 necessary for comfort. One of these, the Chicago, starts on Sept. 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 a berth remains vacant on these ships also. A route patroniseel by the Americans, but not well known to the English, is the Cyprian Favre line from Marseilles. It has truly been said that to sail on these ships is more like embarking on a yachting cruise. Though the fare to and from America costs no more than the more moderate of the English and German charges, the passenger is entertained on board for nearly twice the length of time and visits some most interesting countries. He is taken to Naples, Palermo, and sometimes to Almeria in Spain, or he goes to Lisbon and the Azores, all of which opportunity for sight-seeing is included in the fare to America. Of this line the -7?oi)ia, which leaves Marseilles on 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, the Dominion, and the American line that have passenger ships sailing in the early part of September, and yet, in spite of this extensive choice, it will be found that it is no easy matter 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 their berths. AFFECTIONS OF THE VOLUNTARY MUSCLES. IT can hardly be denied that in proportion to their bulk and 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 general disease they suffer along with all other parts of the body, and some, at all events, of the weakness accompanying exhausting disorders may be due to actual muscular dis- ’, turbance. It is regrettable that with the exception of a few rare 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 recently published in the Proceedings of the Neurological Section of the Royal Society of Medicine 1 by Dr. R. C. Jewesbury and Dr. W. W. C. Topley, in which are set forth the results of their investigations into the histological changes 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 showing increase in the number of their nuclei. In some instances these were grouped into darkly staining masses, while in others they were arranged at the peripheral portions of swollen fibres, presenting when these were cut transversely the appearance of multinucleate giant cells. In acute diseases the muscles may exhibit hyaline or granular degeneration, but often seem normal. Healthy muscle shows little interstitial fat, but in diabetes and pancreatic disease this substance is increased in amount, as is shown not only by microscopical examination but by chemical analysis of the total fat present. An aggregation of fat droplets around the nuclei of the muscle cells is found in many cases and is scarcely to be looked on as pathological. True fatty degeneration of muscle was found constantly in animals infected with a lethal dose of diphtheritic toxin, in which life was prolonged for 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. Mott stated 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 it was here due to exaggerated action of the muscles in the- presence of a profound toxæmia. DEVELOPMENTS IN THE ROYAL SOCIETY OF MEDICINE. THE Council of the Royal Society of Medicine has taken steps 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 of these sections will be antagonistic towards the existing’ societies for the study of these subjects, whose work will thus be supplemented, while we may assume that full advantage- will be taken of opportunities for valuable cooperative- debates. The position of the Ophthalmological Society was explained in these columns last week. That society proposes to maintain its identity, but views with sympathy the pro- posal of the Royal Society to form an Ophthalmological Section, and is considering an alteration of its rules to give practical shape to its support. We understand that in the- case of Fellows of the Royal Society of Medicine who join the 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 be any connexion between blackbirds and the spread of pellagra, but the opinion has been recently expressed that there is a probability that certain migratory birds, and more particularly blackbirds, are acting as reservoirs of the virus of pellagra, and that the actual parasite of the disease will in 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 of Dr, Purdy in his investigations, states that in certain local, areas where pellagra cases have been somewhat numerous, a pellagra-like disease has also been found among horses and cattle. Some horses diecl with symptoms similar to those caused in South America and other tropical countries by trypanosoma equinum. These local areas are also said to> have been infested by migratory birds, more especially blackbirds, which arrive in large numbers from the sunny south 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 migratory birds, 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 that the same species in an animal host often presents many varieties, 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 of the pellagra virus to man and animals, but whether part of the cycle of development of the parasite follows the biting of the blackbird by the infected insect is not yet known. We are told by Dr. Ravitch that in the above-mentioned areas- there has been of late years an unusual plague of flies, and it was observed that where measures were taken to reduce the number of these insects there was less pellagra, -and on the other hand where these measures were neglected there- were more attacks. The conclusion reached by Dr. Ravitch

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Page 1: AFFECTIONS OF THE VOLUNTARY MUSCLES

251

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