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MEDICINE 


447 


motility of the stomach, the emptying was even more rapid with opium 
than without it. In the small intestine they found a delay of the 
intestinal contents under the influence of morphine amounting to 
as much as seven hours. Often only the lower ileum remained filled 
longer than the normal time, suggesting a contraction of the sphincter 
at the ileocecal opening. No alteration could be discovered in the 
tonus of the small intestine. Upon the large bowel, no affect was 
observable, opium and pantopon, noting in practically the same way 
as morphine. In chronic diarrhea with marked hypermotility of the 
small and large intestine, opium produces a alight retnrdution in the 
passage of the contents in the lower part of the small intestine; no 
effect was found on peristalsis of the large bowel down to the sigmoid 
tlexure. The sigmoid remained filled longer than without the mor¬ 
phine. The constipating effect of opiates is due not so much to retar¬ 
dation of peristalsis as to dulling or inhibition of central defecation 
reflexes and the resulting delay of the contents in the sigmoid, Stierlin 
and Schapiro conclude. 

Diastolic Ferment3 In the Urine.—(Dent. Arch. f. klin. Med., 1913, 
iii, 104.) In making determinations of the diastatic ferments in the 
urine, according to Wolilgemut's method, Neumann calls attention 
to the fact that reliable estimations should be based upon the twenty- 
four-hour output. The total dia3tatic ferment amount, per deim,, 
varies much with the same individual, and appears to be influenced 
more by psychic factors than by changes in the diet. Generally the 
diastatic power of the blood serum is les3 than that of the urine. This 
is found to be definitely decreased in diabetes mellitus, the amount of 
reduction being of some prognostic value. It is also diminished in 
pernicious anemia, Basedow’s disease and in some forms of nephritis. 
The notable increase in pancreatic disease, is of real diagnostic, worth. 
There is a slight increase in urinary diastase in some febrile conditions. 
Investigations carried out in a number of other diseases showed no 
great deviation from the normal. 

Experimental Pathology and Therapy of Syphilis—Uni, eniiutu 
and Mulzer (Arb. a. d. Kais Gcsundh. Amt., 1913, xliv, 307) report 
a long and extensive series of investigations carried on in the field of 
experimental lues. Human luetic material was used, after numerous 
passages through dogs, a process winch greatly increases the virulence 
of the spirochete and decreases the incubation time of the disease. 
Intravenous or intracardiac injections of such material in dogs, causes, 
in a high percentage of cases, generalized lues. In from six to ten 
weeks the animals become .unkempt and lean. Soon there appear, 
especially in young animals, small, dark tumors about the nasal orifices, 
the end of the tail becomes knobby, and bean-like excrescences are com¬ 
mon on the edges of the eyelids; these always in association with an 
intense conjunctivitis, These tumors, which commonly show superficial 
ulcerations, contain great numbers of spirochetes. Ulcerated papular 
syphilides may occur around the anus and vagina. In some instances 
the inoculation of extracts of various of the internal organs of such 
animals, into normal dogs, induced lues in the latter. Luetic testicles 
or the occurrence of eye manifestations seem to offer no protection 



448 


PROGIIKSS OK MEDICAL SCIENCE 


against furl her inoculations, nor do the sera of dogs, repeatedly injected 
with spirochetes, protect other dogs from the disease; such sera are 
likewise of no therapeutic value. Uhlenhuth and Mulzer were unable 
to cultivate the spiroc'heta pallidum from infected animals. With refer¬ 
ence to transmission of the disease, it was found after intravenous 
injections of the spirochete, the organisms were able to penetrate the 
sound placenta within five minutes nnd could be demonstrated in 
the fetus. The injection of blood from individuals in the primary or 
secondary stage of lues, caused a specific orchitis in 78 per cent, of 
the eases; even the blood of persons having latent syphilis and showing 
a negative Wassermann reaction can be infectious. Uhlenhuth and 
Mulzer conclude therefore that lues is essentially a chronic septicemia. 

Theory of the Wassermann Reaction.— Praubnitz and Stem ( Zen- 
tralbl. f. BMeriol., 1913, Ixix, 545) in going over the subject of the 
Wassermann reaction it was found that both aqueous and alcoholic 
extracts of luetic livers gave complete complement fixation in the 
presence of luetic sera; alcoholic extracts were much more potent 
and reliable; alcoholic extracts of the residue from the syphilitic livers 
were inactive. It was found that intravenous injections, into dogs, 
of either of the above potent extracts would induce a positive Wasser¬ 
mann reaction in their sera; controls, with normal extracts were 
always negative. Since experimentally the production of an active 
antibody results from the introduction, of a substance or substances 
soluble in alcohol, and probably of a lipoid nature, while on the other 
hand only proteids induce antigen production, it seems reasonably 
certain that the Wassermann reaction is not a true antigen-antibody 
process The reaction is to be considered characteristic when positive, 
but not specific. Whether the lipoids in the reaction originate from 
the luetic tissue or from the spirochetes, remains to be seen. 


The Blcod Picture in Status Lymphaticus.— Siess and Stoerk 
(Wien. mcd. Woch., 1913, lxiii, 1123) give a report of 23 cases, diagnosed 
by reason of the following symptomatology: (1) Atypical arrangement 
of the hair; (2) abnormal length of the extremities; (3) scaphoid scapulas; 
(4) a wide pelvis in males, narrow in women; (5) adiposity of the 
reverse type, in the lower half of the body in males, upper half in 
females; (li) poor development of the breasts; (7) general glandular 
hyperplasia; (8) small but elongated heart associated with a strong 
apex heat and an accentuated aortic second sound; (9) low blood- 
pressure; (10) psychoneurotic manifestations; (11) vagotonia; (12) 
infantile type of epiglottis. The blood findings in such cases showed 
few deviations from the normal picture. Thus the red-blood corpuscles 
varied between 3,000,000 to 5,000,000, the hemoglobin being generally 
high Contrary to a general belief the white cells are not consistently 
low-ranging in this series from 4300 to 10,000. As regards the various 
white cells, the neutrophilic leukocytes, large mononuclears, and transi- 
tionals arc within normal limits; lymphocytes rarely exceed 2000 per 
cc but quite characteristic of them is their unusually abundant 
protoplasm. Eosinophiles are consistently low, whereas the abundance 
of blood platelets is a noteworthy feature. Functional tests of the 
activity of the bone-marrow, made by means of gelatin infections,