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l/ fI246 THE INDIAN MEDICAL GAZETTE [JUNE-JULY, 1046

TABLE TThe effect of dilution on the prothrombintime of patients having Wassermann and Kahnpositive tests as compared with normal controls' Group

Control

Cases havingW.R. and K ahnpositive.

PHOTH KO M BIN TIME OFOF P L AS >

X um-ber

3

1

24

100

19252124

20

171919

A AN SA

Percctiln, I N E ( I N

IO of plamixturesSO

22323031

25

182227

60

23353439

28

212530

MIXTUP.ESSECONDS)

sinn

40

31544052

36

3U2942

in

20

4290SOS5

75

506375K a r k and Lozner {loc. cit.). It is clear thatthis modification does not introduce any erroras the resul ts obtained for normal controls arecomparable with those reported by the originalau thors .

SummaryThe prothrombin t ime in normal Indians,both men and women, has been established bythe macro and micro methods. No differenceis found in the prothrombin t ime of men ascompared with that of women.The normal range by the macro method is 15. to 29 seconds, while the range by micro methodis 18 to 25 seconds.A comparison of the prothrombin t ime ofpatients having posi t ive Wassermann and Kah ntests with normal controls, shows that there isno difference in the two groups even when thedilution method is applied.

Our grateful thanks are due to Sir Sahib SinghSokhey for his interest and encouragement in this work.We wish to thank Drs. D. \V. Soraan and J. P. Menezesfor facilities given to collect samples of blood, andMr. Habbu for helping "in the calculation of thestatistical constants.REFERENCESCLARK. R. L., DIXON. Proc. StaiJ Meet. Mayo Clin.,

C. F., BUTT, H. R., and 14, 407.SNELL, A. M. (1939).D A M , H., and GLAVIND,- Lancet, i, 720.J. (1938).D A M , H., and SCHOX- Biochem. ./., 28, 1355.HEYDER, F. ( 1 9 3 4 ) .D A M , H., SCHONHEYDER, Ibid., 30, 1075.F., and TAGE-HANSEX,E . (1936).FULLEETON, H. W. (1940). Lancet, it, 195.H A W K I N S , W. B., and J. Exper. Med., 63, 795.BRINKHOUS; K. M.(1936).

ILLINC.WOKTH, C. F. W.(1939).I NNES . J.. and DAVIDSON,L. S. P. (1941).IYENHAR. N. K., SHERA,K. R.. and MUKER.II,B. (1942).KARK. R... and LOZNER,E. L. (1939).PAGE. R. C.. and RUSSELL,H. K. (1941).QUICK, A. J. (1938) . .RAHMAN, A., and GIRT,K. V. (1945).REDDY, D. V. S., andVENKATARAMIAH, C.(1941).SCARBOROUGH. H. (1940).ZuCKERMAN, I. C, KoGUT,B., JACOBI, M., andCOHEN, J. Y. (1939).

Laad, i, 1031.Brit. Mrd. ./.. i, 021.Indian ./. Mcd. Res , 30, 339.Lancri, . 1162.. / . ' Lob . !(/ Clin. Med., 26,

1366 ./ . Amer. Med. ARSOC. 110,1658.Ann. Biochcin. and ExpcrMed., 5, 17.Indian Mcd. Gaz., 76, 341.Lancet, i. 10S0.Amer. J. Digest Dis., 6, 332.

C U R A T I V E T R E A T M E N T O F L A T H Y RI SM ,A D I S E A S E OF THE N E R V O U S S Y ST E M

By H. JACOBY, M.D.Chief Physician, Prince of Wales Hospital, Bhopal,Bhopal StateIN a majori ty of diseases of the nervous sys-tem, nei ther a cause nor a cure is known ; viz,in multiple sclerosis, syringomyelia, amyo-tropic lateral sclerosis, spastic spinal sclerosis,etc. /;. - .Tn vast areas of India including Bhopal, adisease prevai ls named ' lathyrism ', the symp-toms of which are identical with those of spas-tic s pina l sclero sis. AVhile for the lat terdisease we have no answer even to the question,whether exogene or endogene causes are respons-

ible, we know in the case of lathyrism beyondany doubt that an exogene agent is the solecause of it, namely the seed of Lathyrus sativus.In th i s par t of India , we have come across nocase of lathyrism which has been contractedwi thout the consumption of Lat h y ru s as staplefood for a period of at least a few months .Th ere is no cure for spastic spinal sclerosis(Beaum ont, .1942; Price, 1941), nor for lathyr-ism. In a recent review on all t h a t is knownof lathyrism, Shourie (1945) "writes : ' As far asat present known, the nervous lesions are per-m an en t and the disease incurable. ' For lathyr-ism we have, however, found a drug whichhas defini te curat ive propert ies .Acetylcholine is a kind of hormone (Loewi)present in the h u m an b o d y and p l ay s the mostimportan t r le in the transmission of the nerveimpulses. Un der norm al condit ions, acetylcho- ;line is des t royed by cholinesterase only whenit has served its purpose. # ,We know, however, a pathological condition-,(myas thenia gravis ) in which it hasassumed that e i ther an unbalance between _duction of acetylcholine and its destruction by:jcholinesterase exists (McGeorge, 1937)causes disease, or in which the presence

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JUNE-JULY, 1946] THE ELECTRON MICROSCOPE & ITS USE IN BIOLOGY : SEN 247a poison-like loxic substance (for instancecurare) interferes with the normal transmission$& of impulses in the motor nerves (Fraser, 1938).|j- For the treatment of lathyrism we went to| work with the hypothesis that in consequencegy. of the lathyrus intoxication the anatomical and^ functional lesions in the upper motor neuroneJf' of the pyramidal tract go along with an un-| : balance between production and destruction of

| acetylcholine, thus interfering with the normal| transmission -of co-ordinated nervous impulsesJi in the tract and causing the described symptoms.% With a view to restituting this unbalance, wes|: resorted to a drug known to protect acetyl-H choline against its destruction. Such a drug is&; the alkaloid physostigmine or eserine, Decur-ia ring in the Calabar bean, the seed of thef . plant Physostigma venenosum. Since, however,H physostigmine has very undesirable toxic by-p effects, we rather used its synthetic equivalent,|& by name prostigmin (Roche), which has exactlythe same pharmacological properties as physos-tigmine. The same preparation has been usedso successfully in myasthenia gravis by Walker(1935).A confirmation of the above concept thatprostigmin may facilitate the normal transmis-sion of nervous impulses in the pyramidal tractalso, is given by the experiments of Schweitzerand Wright (1937), who have shown thatprostigmin depresses the knee-jerk-reflex throughdirect inhibitory action on the spinal cord. Andit is known that the exaggerated deep reflexes, upto ankle- and patellar-clonus, are among thecharacteristic features in lathyrism." Whatever the theoretical considerations on.the mechanism may be that led us to tryprostigmin for the treatment of lathyrism, the1| results achieved so far mark a conspicuous ad-w vanee in the treatment of this disease.We injected 1 c.cm. of prostigmin methyl-|i sulfate containing 0.5 mg. into 14 patients intra-muscularly every day.We achieved a full success on 8 patients, i.e.| 57.1 per cent, each of whom received twelve"^injections. The success consists of abatementJof the muscular rigidity and spasm in the lowerI extremity as well as of all pains in the muscles% of the calf and thigh, and occasional pains in the lum bar region. The gait of these patients,which, previously had been spastic-paretic,.became almost normal.Three cases, i.e. 21A per cent, were greatly.improved: Some resistance, however, in the'.rnuscles of the lower extremity on walking isnoticeable and a slight ataxia exists bystanding on one foot with closed eyes. Th isigroup of patients has also no pain, any more.Two; of them received twelve injections, onieReceived 24 injections.lie third group of patients, three in number(21.4 per cent), were practically not improved,|ltjbgh they adm itted th at their pain wasRelieved and that on walking they did no more ;geraten/ the ground '.

If we classify the cases into four groupsaccording to the severity of the symptoms, wemay say that those who are practically curedbelong to groups I and II, who are "greatlyimproved to group III and those who up tothe present appear incurable to group IV.I t may, however, well be that with an im-provement of our technique our results will stillimprove and we shall give a full account of allour findings on a greater number of patients indue course. Eventually, we may express ouropinion that in view of the identity of clinicalsymptoms of lathyrism with spastic spinalsclerosis, the above treatment may also beapplicable with success in the latter disease.We, however, see such cases very sparingly inIndia, if at all.

SummaryLathyrism is a nervous disease of the uppermotor neurone in its clinical aspect identicalwith spastic spinal sclerosis. But whereasfor the latter disease no cause and no cura-tive treatment is known, we are well aware ofthe cause of lathyrism, i.e. consumption of theseed of Lathyrus sativus (Teo ra). With regardto treatment, we have found that prostigmin,the synthetic equivalent of physostigmine, hasdefinite curative properties if given as injec-tion for a sufficient length of time. In this way,we treated 14 patients altogether, eight of whom,i.e. 57.1 per cent of the milder ones, were prac-tically cured. Three, i.e. 21A per cent, weregreatly improved and three, i.e. 21A per centof the' far advanced cases, were not improved sofar.

REFERENCESBEAUMONT, G. E. (1942).FRASER, F. R. (1938) . .MCGEORGE, M. (1937) . .PRICE, F. W. (1941) . .SCHWEITZER, A., andWRIGHT, S. (1937).SHOURIE, K. L. (1945). . .WALKER, M. B. (1935) ."..

Medicine. J. and A. Churchill,Ltd., London.Brit. Med. J., i, 1349.Lancet, i, 69.A Textbook of the Practiceof Medicine. Oxford Uni-versity Press, London.J. PhysioL, 39, 165.

.Indian J. Med. Res., 33, 239.Proc. Roy. Soc. Med., 28,759.T H E E L E C T R O N M IC RO S CO P E AND ITSU S E IN B I O L O G Y

By A. N. SEN, M J.{Bengal Immunity Research Laboratory, Calcutta)' T H I S outstanding tool of research100times as powerful as the best optical micro-scope, could magnify a dime to more than amile wide, a human hair to over forty feet inbreadthapproaches revelation of the verymolecules themselves 'with these words com-pliment was paid to Burton and Kohl, who forthe first time constructed an electron micro-scope and thereby opened a new chapter in therealm of physical science.