X-RAY TREATMENT OF THE COMMONER MICROBIC DISEASES OF THE SKIN
Authors: J. B. Higgins
Journal: BMJ (1929)

IMEDICAL JOURNA t'tho evideonce of miiental.deterioration was still ratllier in- dlefiniite.A better illustration of the second " biotype " is a memiber of a previous generation of the ).In this patienit, a miiale, movemenits were presenit for thlirty years--fromn tlho age of 40 ultil deatlh at the age of 70- aild nio mental syml)toms appeared.A third " biotype," thlat in which the disease appears early3 in life, miiiglht be huaggeste d by two patielnts in the tliriid genieration (Nos.5 and(1 6).As, however-, it lhas niot beeln possible to obtain access to these patienits, it is difficullt to decide wlhethler they had suffered from Sydenlihaimi's cliorea at the age of 10 anid the movements hlad persisted as a mimiesis, whlletler they suffered fromi a coniversion hysteria as a result of ;ala.(lptationduo to a slight defect of menltality, or whether they suffered from a trtue "biotype" of Hunitiing- toii's cllorea. Th fact that the latter disease hlad not .affectedeither of their parents wvould suggest, however, th.at onie of the former conditions was presenit.Ani aniatomical feature coinmmoin to the two cases recorded wais the presence of an extrapyramidal type of rigidity, p)resuniably as a result of the partial release of the l)ostural ieflex path from cortical control.Iu the first patienit it was comparatively slight; in the second patient it wvas extremiie oni the side on which the clhoreic miiovementi s w-ere n-ost pronounced, and present in lesser degreo on the side unlaffected by the miiovements.It would appear, therefore, that although the lesion usually affects the basal strutcturcs responsible for the coniductioni of the afferent impulses (ontrollinig volunitary mloveiienits, it may affect otlher1 basl1 structurls first and produce some degree of extrapyramidal rigidity -before the onset of choreic mov-eenlts and(l (lelnlenitia.Coimmzeiitery on the Fanmily hlistoryl.An investigatioin of the family history of the patiflets re,vealed the preselnce of five otlher definiite cases of Hunitington's chorea in the two previous generations.There was nlo informiiiation available about thc histor-y of the faimlily outside thle thlree genlerations.Ini the first generation onie miiale and two females were affected.The formiier died uinmarried, wv' le each of the lattel tr'ans- initted the disease to one soni.There was n0o evidenice of thle occurrience of the disease in the offsprinig of the un- affected niemibers of the family, apart from the two doubt- ful cases (Nos. 5and 6).In tlle second genierationi only two imiales were affected.The first male (No. 4) did not transmiit the disease, but the second male (No. 7) trans- miiitted it to two daugliters.It miglht appear that the dlisease, wlicli affected both males anid femiiales ill the first genieriation, affected onily males in the second genieration, and only females in the tllird generatioln.This observationi is, hiowever, invalidated by the fact that in the second * Read in opening a discuission at a joint meeting of the Sections of Dermatology and Radiology and Radio-Therapeiutics at the Anniual Meketing of the British Medical Association, Mlanchester. 1929.