l/ fI

246
T A B L E T

THE INDIAN MEDICAL GAZETTE

ILLINC.WOKTH, C. F. W.

[JUNE-JULY, 1046 Laad, i, 1031. Brit. Mrd. ./.. i, 021. Indian ./. Mcd. Res , 30, 339. Lancri, . 1162.
./.' L o b . <?>!(/ Clin. 1366. Med., 26,

The effect of dilution on the prothrombin time of patients having Wassermann and Kahn positive tests as compared with normal controls
' Group
TIME OF MIXTUP.ES OF PLAS> A A N SA ,INE ( I N SECONDS) PHOT H KO M BIN

(1939).
INNES. 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). Control X umber 100 19 25 21 24 20 17 19 19 SO 22 32 30 31 25 18 22 27 60 23 35 34 39 28 21 25 30 40 31 54 40 52 36 3U 29 42 20 42 90 SO S5 75 50 63 75

Percctiln IO of pla sinn in mixtures

QUICK, A. J. (1938)
RAHMAN, A., and

..
GIRT, and C.

/ . Amer. Med. ARSOC. 110,

K. V. (1945).
REDDY, D. V. S., VENKATARAMIAH,

1658. Ann. Biochcin. and Expcr Med., 5, 17. Indian Mcd. Gaz., 76, 341.

Lancet, i. 10S0. ZuCKERMAN, I. C , KoGUT, Amer. J. Digest Dis., 6, 332.

SCARBOROUGH. H. (1940).
B., JACOBI, M., and

(1941).

COHEN, J. Y. (1939).

Cases having W.R. and Kahn positive.

1 2 4

CURATIVE TREATMENT OF LATHYRISM, A DISEASE OF THE NERVOUS SYSTEM

By H. JACOBY, M.D. Chief Physician, Prince of Wales Hospital, Bhopal, Bhopal State

Kark and Lozner {loc. cit.). It is clear that this modification does not introduce any error as the results obtained for normal controls are comparable with those reported by the original authors.

Summary
The prothrombin time in normal Indians, both men and women, has been established by the macro and micro methods. No difference is found in the prothrombin time of men as compared with that of women. The normal range by the macro method is 15 . to 29 seconds, while the range by micro method is 18 to 25 seconds. A comparison of the prothrombin time of patients having positive Wassermann and Kahn tests with normal controls, shows that there is no difference in the two groups even when the dilution method is applied. Our grateful thanks are due to Sir Sahib Singh Sokhey for his interest and encouragement in this work. We wish to thank Drs. D. \V. Soraan and J. P. Menezes for facilities given to collect samples of blood, and Mr. Habbu for helping "in the calculation of the statistical constants. REFERENCES
CLARK. R. L., DIXON. Proc. StaiJ Meet. Mayo Clin.,
C. F., BUTT, H. R., and 14, 407.

SNELL, A. M. (1939). DAM, H., and GLAVIND,- Lancet, i, 720.

J. (1938).
DAM, H., and SCHOXTAGE-HANSEX,

Biochem. ./., 28, 1355. Ibid., 30, 1075.

HEYDER, F . (1934).

DAM, H., SCHONHEYDER,

F., and

E. (1936). FULLEETON, H. W. (1940). Lancet, it, 195.

HAWKINS, W. B., and
K. M.

J. Exper. Med., 63, 795.

BRINKHOUS;

(1936).

IN a majority of diseases of the nervous system, neither a cause nor a cure is known; viz, in multiple sclerosis, syringomyelia, amyotropic lateral sclerosis, spastic spinal sclerosis, etc. /;. - . Tn vast areas of India including Bhopal, a disease prevails named ' lathyrism ', the symptoms of which are identical with those of spastic spinal sclerosis. AVhile for the latter disease we have no answer even to the question, whether exogene or endogene causes are responsible, we know in the case of lathyrism beyond any doubt that an exogene agent is the sole cause of it, namely the seed of Lathyrus sativus. In this part of India, we have come across no case of lathyrism which has been contracted without the consumption of Lathyrus as staple food for a period of at least a few months. There is no cure for spastic spinal sclerosis (Beaumont, .1942; Price, 1941), nor for lathyrism. In a recent review on all that is known of lathyrism, Shourie (1945) "writes : ' As far as at present known, the nervous lesions are permanent and the disease incurable.' For lathyrism we have, however, found a drug which has definite curative properties. Acetylcholine is a kind of hormone (Loewi) present in the human body and plays the most important rle in the transmission of the nerve impulses. Under normal conditions, acetylcho- ; line is destroyed by cholinesterase only when it has served its purpose. , # We know, however, a pathological condition-, (myasthenia gravis) in which it has assumed that either an unbalance between _ duction of acetylcholine and its destruction by : j cholinesterase exists (McGeorge, 1937) causes disease, or in which the presence

*t

JUNE-JULY,

1946] THE ELECTRON MICROSCOPE & ITS USE IN BIOLOGY : SEN 247 If we classify the cases into four groups according to the severity of the symptoms, we may say that those who are practically cured belong to groups I and II, who are "greatly improved to group III and those who up to the present appear incurable to group IV. It may, however, well be that with an improvement of our technique our results will still improve and we shall give a full account of all our findings on a greater number of patients in due course. Eventually, we may express our opinion that in view of the identity of clinical symptoms of lathyrism with spastic spinal sclerosis, the above treatment may also be applicable with success in the latter disease. We, however, see such cases very sparingly in India, if at all. Summary Lathyrism is a nervous disease of the upper motor neurone in its clinical aspect identical with spastic spinal sclerosis. But whereas for the latter disease no cause and no curative treatment is known, we are well aware of the cause of lathyrism, i.e. consumption of the seed of Lathyrus sativus (Teora). With regard to treatment, we have found that prostigmin, the synthetic equivalent of physostigmine, has definite curative properties if given as injection 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 practically cured. Three, i.e. 21A per cent, were greatly improved and three, i.e. 21A per cent of the' far advanced cases, were not improved so far. REFERENCES
BEAUMONT, G. E. (1942). Medicine. J. and A. Churchill, FRASER, F. R. (1938) . . MCGEORGE, M. (1937) . . PRICE, F . W. (1941) ..
SCHWEITZER, A.,

a poison-like loxic substance (for instance curare) 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 consequence gy. of the lathyrus intoxication the anatomical and ^ functional lesions in the upper motor neurone Jf' 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 impulses Ji in the tract and causing the described symptoms. % With a view to restituting this unbalance, we s|: resorted to a drug known to protect acetylH choline against its destruction. Such a drug is &; the alkaloid physostigmine or eserine, Decuria ring in the Calabar bean, the seed of the f. plant Physostigma venenosum. Since, however, H physostigmine has very undesirable toxic byp effects, we rather used its synthetic equivalent, |& by name prostigmin (Roche), which has exactly the same pharmacological properties as physostigmine. The same preparation has been used so successfully in myasthenia gravis by Walker (1935). A confirmation of the above concept that prostigmin may facilitate the normal transmission of nervous impulses in the pyramidal tract also, is given by the experiments of Schweitzer and Wright (1937), who have shown that prostigmin depresses the knee-jerk-reflex through direct inhibitory action on the spinal cord. And it is known that the exaggerated deep reflexes, up to ankle- and patellar-clonus, are among the characteristic features in lathyrism. " Whatever the theoretical considerations on .the mechanism may be that led us to try prostigmin for the treatment of lathyrism, the 1| results achieved so far mark a conspicuous adw vanee in the treatment of this disease. We injected 1 c.cm. of prostigmin methyl| i sulfate containing 0.5 mg. into 14 patients intramuscularly 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 abatement Jof the muscular rigidity and spasm in the lower I extremity as well as of all pains in the muscles % of the calf and thigh, and occasional pains in the lumbar 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 is noticeable and a slight ataxia exists by standing on one foot with closed eyes. This igroup of patients has also no pain, any more. Two; of them received twelve injections, onie Received 24 injections. lie third group of patients, three in number (21.4 per cent), were practically not improved, |ltjbgh they admitted that their pain was Relieved and that on walking they did no more ; geraten/ the ground '.

Ltd., London. Brit. Med. J., i, 1349. Lancet, i, 69. A Textbook of the Practice of Medicine. Oxford University Press, London. and J. PhysioL, 39, 165.

WRIGHT, S. (1937). SHOURIE, K. L. (1945). . . .Indian J. Med. Res., 33, 239. WALKER, M. B. (1935) .".. Proc. Roy. Soc. Med., 28,

759.

THE ELECTRON MICROSCOPE AND ITS USE IN BIOLOGY

By A. N. SEN, M J .
{Bengal Immunity Research Laboratory, Calcutta)

' THIS outstanding tool of research100 times as powerful as the best optical microscope, could magnify a dime to more than a mile wide, a human hair to over forty feet in breadthapproaches revelation of the very molecules themselves 'with these words compliment was paid to Burton and Kohl, who for the first time constructed an electron microscope and thereby opened a new chapter in the realm of physical science.