Vol. 60, 1909 - University of North Carolina at Chapel Hill

SS
THE CHARLOTTE MEDICAL JOURNAL.
servation that the heart quickens its action, experimental arterio SCLEROSIS by
there is an increased output of blood into the use of alcohol.
the arterial system and the pulse tension is As a result of the use of the higher aniraised.
A similar effect upon the circula- mals for teaching and experimental purtory
system can be produced by other gastric poses, there has developed in this countryirritants
such as ammonia, ether, and cap- an enormous amount of literature along thesicum.
This stimulating action of the drug line of experimental pathology. Such work
is very likely a gastric reflex. To deter- is not only essential to the proper teaching,
mine this point we have on several occa- of several of the rudimentary branches in
sions anesthetised a rabbit with Chloral the medical curriculum but it is the only
Hydrate Solution and connected the ani- way which many problems in pathology
mal's carotid artery to a mercury manome- and pathological physiology can be apter
so as to accurately record the arterial proached and solved.
pressure. At intervals of 1.^ minutes a The blood vessels of the lower animals
small soft rubber catheter was introduced
into the animal's stomach and ,iO c.c. of a
30 percent solution of Ethyl Alcohol adminwere
early used as a field for such experi-
mental work. Among the investigators
who have attempted to produce atheromaistered.
The heart's rate and the animal's tons changes in the vessels are Josie, Fischer,
blood pressure were recorded every five min- Kurt, Klotz, and Miller. \'arious drugs
utes. There was no appreciable rise in and other agents have been employed but
blood pressure and but a very slight accel- the most satisfactory results have been oberatiou
of the heart. These experiments tained by Miller who used solutions of Adcertainly
support the belief that the accel- renalin and Physostigmine.
eration of the heart after the use of alcohol It is a well known fact that the majority
i.s a gastric reflex from irritation and that of individuals who use alcohol continuouswheu
the reflexes have been abolished as a ly, develop some type of arterio-sclerosis.
result of the anesthesia the quickening of The severity of the process varies from a
the heart and the subsequent rise in pressure slight induration of the aortic valves and a
from alcohol does not occur. few atherematous patches in the aortic arch
I am firmly of the belief that there are car- to a diffuse arterial sclerosis which exists in
tain infectious diseases in which alcohol is the peripheral vessels as the classical ' pipe
of the greatest value as a circulatory sup- stem" arteries.
port. I do not say stimulant, for with the It was the object of our investigations, to
ordinary interpretation of this term it would determine first if such changes could be
convey a false meaning. In Pneumonia, produced experimentally by alcohol in the
Typhoid Fever, and more rarely Tubercu- vessels of the lower animals. Secondly to
losis we frequently see patients with a fast determine, if possible, if these changes were
heart, a soft, small pulse, rapid respira- due, per se, to the alcohol or if other sections,
and muttering or maniacal delirum, ondary factors entered into their produc-
In short these are outward manifestations tion, and thirdly to attempt to find some
of an over stimulated central nervous sys- remedial agent which would have either a
tem. The stimulus is the toxin and it at first direct or indirect influence upon the morbid
gives rise to this picture of stimulation, and process.
unless it is stopped leads to over stimulation. The rabbit was. the animal chosen for this
fatigue, and a state of inactivity of the Cen- work as they are comparatively cheap and
tral Nervous System which is manifested by easy to handle. The alcohol was givenljy
a state of coma which frequently precedes the stomach through a soft rubber catheter,
death. For the first few days 2,5 c,c. of a 10 per-
In such cases following the use of alco- cent solution was given and after this the
hoi, especially in Pneumonia it is a common amount was increased to ,S0 c.c. and the
observation to note that the delirium les- strength of the solution to 20 percent. A
sens, sleep is induced, the heart's action be- few of the animals died from accidental
coming slower and stronger. The cells causes. In those that lived the alcohol
of the arterial nervous system are so de- was continued for nearly eight weeks. At
pressed that they no longer respond to the end of this time the rabbits were killed
the stimulus of the toxin, the state of fatigue by chloroform, complete post-mortems were
is prevented and the integrity of the cell is held, and the heart, aorta, and iliac vessels
maintained. It has been clearly demon- were removed for microscopic study
strated experimentally by UoUy that as a There were fourteen animals in this first
result of overstimulation structural changes series which were subjected to the action of
of a degenerative nature develop in the cells Alcohol as described above. Of the fournf
the central nervous system and further- teen animals the vessels of ten showed disraore
that these changes frequently lead to tinct evidence of some type of arterial dean
actual rupture and death of the cells. generation. These changes varied greatly
.