The Key West citizen. [volume] (Key West, Fla.) 1879-current, 1946-11-26

CleSs SOmeumeS turning the ne
The new methods were del
director of the Neurological In !
stitute of New York, before the
recent Inter-American Medical
Congress in Rio de Janeiro.
The two diseases are more dis
tresSing and apparently more
common than infantile paralysis,
DIR Putnam said.
Shaking palsy, or paralysis agi-
tans. brings uncomfortable shak-
ing Of the hands, arms, or head,
with some rightly. The second
disease-called dystonia or athe-
tosis--makes muscles of the arms,
legs, neck or trunk contract in
voluntarily and almost eontinu-
ously. The rigid muscles may
witch.
The surgery tries to stop alb
normal nerve signals producing
these effects, DR.. Putnam ex-
planned. It has enabled few per-
sons 10 return to work. One is
using a typewriter with hands
that once could not be kept still.
In about IS per cent of cases,
operations can bring relief of the
trembling or contractions, and
often Of pain, but they are not a
cure, he said. They seldom relieve
the rigidity. and may leave the
tremor-affected arm or leg wax
oned.
Medicines sometimes help some
what in both ailments. What
causes the abnormal nerve signals
is not known, DR.. Putnam said,
bat operations are helping to ex-
plain their mechanism.
The first operation tried, for
dystonia, removes part of the
motor cortex from the top of the
brain. First performed in Eng
land in 1909, it was developed
considerably in recent years by
Dr. Paul Buoy of Chicago and by
DR. Roland Klemme of ST. Louis.
IL works we'll for spasms of the
arm, but less we'll for those of
the leg, face, or neck, and achieves
extremely good results in select
ed cases, DR.. Putnam said.
A second operation, also for
dystonia, was developed by DIR.
Putnam and his associates. It is
done in the neck on nerve
channel in the spinal cord. The.
reasoning was that the abnormal
signals from the brain might be
stopped before they reached the
nerves going to the body extremi-
ties.
But here strange fact in mans
evolution had to be considered.
Man has two sets of nerve chan
neis or tracts in the spinal cord.
One is found in lower animals,
even in fishes, and still is retain
ed in man. The other set, the
pyramidal tract, is well-develop-
ed only in man and monkeys.
There was evidence that the
old nerve channel was respon-
sibie for the muscle contractions
in dystonia, and an operation of
cutting into this old pathway was
first tried on a girl who was in
great pain. 1t worked successfully.
II has had about the same pro-
portion of success as the opera
ton on the brain motor center,
and can be used when paralysis
affects both sides of the body, DR..
Putnam said.
But this method had no effect
on shaking palsy. Apparently the
nerve impulses causing the trem-
or were transmitted along the py-
randall tract, not the old motor
channel.
But would cutting into mans
main nerve tract produce severe
paralysis? Tests with monkeys
indicated it would not. The oper-
alton was first carried out on a
patient who had been completely
incapacitated for Is years. It
brought marked relief and has
been used successfully with nu-
merous patients, Dr.. Putnam said.
One puzzle, he continued, is
why a given operation works in
one case but not another.
DR. Putnam also is professor of
neurology and neurological sur
gerry at the College of Physicians
and Surgeons, Columbia Univer-
Sity, and now is on sabbatical
leave.