ACTA MEDICA
`SCANDINAVICA
`
`SUPPLEMENTUM CCVI (206)
`
`COMPTES RENDUS DU VINGTIEME
`CONGRES DE MEDICINE INTERNE
`DES PAYS DU NORD, REUNI A
`GOTHEMBOURG DU 27 AU 29 JUIN
`1946.
`
`PURLIES PAR LE SECRETAIRE GENERAL
`DU CONGRES, LE PROFESSEUR
`
`MARTIN ODIN
`
`HELSINGFORS 1948. MERCATORS TRYCKERI
`
`This material WBSCOniarl
`
`Ex. 1059 - Page 1
`
`

`

`TABLE DES MATIkRES
`
`
`
`1
`
`7
`
`17
`
`20
`
`29
`
`35
`
`Pag.
`Listc des menthres du emigres
` XII
`Discours prononce par le professeur SVEN INovnit, Lund, president
`du emigres: (cid:9)
` XVIII
`
`
`
`1. OTTO JEnvni.i., (Oslo): Intravcntricular Conduction Disturbances
`in Cardiac hypertrophy (cid:9)
`2. I lAnox IIASMUSSEN and TORJ US Mou (Oslo): On the Pathogenesis
`and Clinical Importance of the Left Bundle Branch Block Electro-
`cardiogram
`Discussion: NYLIN
`3. II ICIIA RD I. OHNELL (Stockholm): Some PQ problems
`
`Discussion: lill,DEN (cid:9)
`-I. B. CHR. CHRISTENSEN (Copenhagen): On the electrocardiographic
`changes in normal man brought about by changing the carbon
`dioxide tension in the arterial blood
`5. GUNNAR MALmicrnOm (Stockholm): A Modification of the Cardiolo-
`gical Hypoxemic Tolerance Test
`Discussion to 4 and 5: BIORCE, MALMSIROM, CHRISTENSEN, WAR-
`BURG, NIALNISTROM, NYLIN
`6. IN G A I.INDUREN (Stockholm): A study of cardiac pain by means of
`local anaesthesia of the precordium and section of the sympathetic
` 37
`pathways
`7. E. Itom.si:N (Silkeborg): On the Treatment of Auriculoventricular
`Dissociation with Adrenergic Substances
`8. KARL. ERIK GRIMM (Stockholm): Suitable methods in chest-wall lead
` 51
`electrocardiograms
`9. G UNN A R Inoncx (Stockholm): Cardiology in North America
`66
`Discussion: NYLIN, GRENVIN
`75
`10. B. r A LLBERG, F. L UND, I. G. Ponid and J. TILLGREN (Stockholm):
`The Treatment of Hypertension with Nitroglycerin Preparations 76
`Discussion: ASK-UI'MARK, TILLGREN
`79
`11. PENTTI I. I i A LONEN (Helsingfors): On the treatment of hypertension
`with thiocyanate
`TILLGREN, HAMMARSTRoM
`Discussion: A (cid:9)
`12. M. Cn. EnusTnom (Helsingfors): Enlargement of the heart in hyper-
`
`
`
`tension
` 86
`Discussion: ASK-I '1,NIA RE , EIIRSTROM, NYLIN, PORJ 1,, 1 IANIMAR-
`STR ijM
`
`50
`
`81
`85
`
`93
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`Ex. 1059 - Page 2
`
`(cid:9)
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`(cid:9)
`(cid:9)
`(cid:9)
`(cid:9)
`(cid:9)
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`(cid:9)
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`(cid:9)
`

`

`VI
`
`94
`1111
`
`102
`
`109
`
`112
`122
`
`
`
`
`
`13. SVEN 1lAmMARsTikom (Stockholm): The variability or blood pre,.nl`.
`in hypertension (cid:9)
`Discussion: IIINI. I lol.sr, I lAmmAnsTRDM .................... (cid:9)
`14. FLEstsitsio ICsAstuot: (Copenhagen) and S. SANWELssoN, lice141"
`vik: Isolated rypertrophy of the Hight Ventricle of tbi• i icait
`of I 'nknown
`15. Joimr:s: E. Tit (cid:9)
`(Copenhagen): On the mechanism of shock or
`General reaction Of c, II, and organisms to injury (Outline of a work-
`ing hypothesis) ............................................. • (cid:9)
`16. S. ItLifi.i•NE) (Stockholm): Variations in the quantity of red blood
`corpuscles in ca ..• . of heart failure ............................ (cid:9)
`• (cid:9)
`Discussion: I (cid:9)
`I:, WARBURG, NVLIN. 111:1)LuN" ............... (cid:9)
`17. T. i:soN i.r.hi . Nykoping): •Endothoracic , or .Posterior
`tation.,a New Method of Examination of t he I leart, Preliminary It eitort 123
`131
`Discussion: NV mutroo
`Wsinirim (Copenhagen): Clinical experien-
`18. .ImmEN VioisT and (cid:9)
` 132
`ces concerning the effect of strophanthin (cid:9)
`144
`Discussion: Nyl.iN, WARBURG
`
`19. I. G. Pifitri': (stockholiii): Contribution to the diagnosis or stenosis
`aortic isthmus (Not submitted for publicatio)
`n
`''')" (cid:9)
`1)1 t (cid:9)
`I fisrussion: TILLiotEN. LINDQvisT, l'')"".
`20. Ysinve. 1,AGssoN (tit ockholn):The vasoconstrictor tone of the cutaneous
`arterioles in acroasphyx1a, 11‘pi'lleluslon and in the cold pressor test. 146
`1.'15
`Discussion: liAmstAns•rnost
`
`21. TonsTEN 1,INDQVNT (Gothenburg): The value of various examination
`II" hods In diagnosing arterial disease to the extremities
`22. it. (cid:9)
`n (cid:9)
`(Stockholm): An account of the Work -Tonseillography com-
`pared with other diagnostic tests
`\
`Discussion to 20, 2/ am/ '1, 9: 1 IAMMAID4114DM, LAIIISsoN, C11111.411 \ (cid:9)
` 185
`LINDQVIST
`(Stockholm): Studies in the Form of the Pulse Wave
`23. G. (cid:9)
`In 1)1st:a Arteries of the Extremities with Clinical Applications. . (cid:9)
`Discussion: Poluf;
`21. Elm:mug 1.11ND (Stockholm): Percutaneous Nitroglycerin Treat -
`ment in Cases of Peripheral Circulatory Disorders, Especially 11:1
`maul's Disease
`25. W. THLINE ANDERSEN (SVCIldborg): ThroMbophlebitis saRalls with
` 207
`
`special Etiology
`Discussion: LINDQVIST, ANDERSEN
` 211
`26. BENGT IlosENunEN (Gothenburg): The value of anticoagulant drugs
`in thrombosis of the retina (cid:9)
` 212
`27. FLEMMING RAASCHOU (Copenhagen): ifydronephrosis and Arterial
`Hypertension (cid:9)
` 217
`Discussion: BECHGAARD
` 224
`28. CLAUS BRUN, TAGE HILDEN and FLEMING RAASCHor (Copenhagen):
`On the Effects of Mersalyl on the renal function (cid:9)
` 225
`Discussion: BliiRCK (cid:9)
` 225
`
`115
`115
`
`!-5 !":6 1
`
`1118
`
`189
`193
`
`190
`
`This material was copi ed
`at the NLM and may be
`Subject US Copyright Laws
`
`Ex. 1059 - Page 3
`
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`

`

`VII
`
`29. Nim.s Pra•:n Elms (Copenhagen): Procaine comme remede diuretique
`en cas d'anurie Ague (cid:9)
` 227
`Discussion: STORM-MATHISEN
` 240
`30. TAni: I fttnEN (Copenhagen): Diodrast Clearance in Essential Hyper-
`tension
` 212
`31. 'I'm ;E I fiLDEN (Copenhagen): Diodrast Clearance in Acute and Cronic
`(1Iomerulonephritis
` 246
`32. 111116E11 SWEDBERG (Stockholm): Plasma transfusions—Practical advice 251
`Discussion: LAGERLOF, SwEnniain
` 259
`33. E. ABRAMSoN (Stockholm): Summarizing Survey of the Food Con-
`ditions in Sweden during the Second World War
` 260
`34. KNUT AAS (Oslo): Internal diseases in the. German concentration
`camp 4Grinio in Norway (cid:9)
` 269
`35. KN. 01.EsEN and E. ScnionT (Aalborg): Hyperthyroidism in children 278
`Discussion: ELDH (cid:9)
` 283
`36. A. Bum.: FRISK (Stockholm): Treatment of hyperthyroidism and
`heart failure with methylthiouracil (cid:9)
` 284
`37. E. MmiLENonAcirr, K. KJERULF-JENSEN and K. SCHMITH (Copen-
`hagen): Continuous Treatment with Methylthiouracil in Thyrotoxic
` 293
`Goiter
`38. A. I LARRESTRUP ANDERSEN (Copenhagen): Pre-operative methyl-
` 299
`t hiouracil treatment of lodideresistant Graves' disease patients
`39. K. Kar.mil.F-JENsEN and E. MEULENGRACHT (Copenhagen): Some
`Experiences with Propyl-Thiouracil in the Treatment of Graves'
` 304
`Disease (cid:9)
`Discussion to 36-39: JOSErtioN, SVARTZ, LUNDBAEK, KALLNER,
`FRISK, JOSEFSON, MEULENGRACHT, KJERRULF-JENSEN, KALLNER 306
`40. ERIK LANDBOE-CHRISTENSEN and CLAUS MUNK PLUM (Copenhagen):
` 309
`Localization of the anti-anemic principle in the human stomach (cid:9)
`41. E. LANnuoi:-ClinisTENsEN and C. L. S. BOHN (Copenhagen): On the
`curative effect of pure duodenal secretion from swine in cases of per-
` 311
`nicious anemia
`MEULENGRACHT, IVERSEN, SALTZMAN, WAL-
`Discussion to (cid:9)
` 312
`DENSTROM, DEDICHEN, LANDBOE-CHRISTENSEN
`42. JAN WALDENSTROM (Uppsala): Experiences of folic acid treatment.
` 314
`(Not submitted for publication)
`43. TAGS ESPERSEN and JoRGEN JORGENSEN (Copenhagen): Folic acid
` 315
`therapy in liver-resistant l:ernicious anemia
`Discussion: DmarcunN, BJORNEBOE, MEULENGRACHT, WALDEN-
` 320
`STRiiM, MOTZFELDT, JoRGENsEN
`44. FlIEDITIK SALTZMAN (Helsingfors): Penizillin bei aplastischer Anaemi
` 321
`and Granulozytopenie
` 325
`Discussion: SVARTZ, WALDENSTROM (cid:9)
`45. HALL SCIIARTUM-1 fANSEN (Oslo): On paramyeloblastic leukemia (cid:9) 326
`46. C. 0. 01.ntiur and D. KNUTSON (Stockholm): Chronic benzene
` 331
`poisoning
` 342
`Discussion: FonssmAN. WESTERGREN, OLHAGEN
`
`This material was copied
`et the biLM and may be
`Subject LISCopyright Laws
`
`Ex. 1059 - Page 4
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`(cid:9)
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`(cid:9)
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`

`

`VIII
`
`produced neur(,K(Ix '
`
`
`47. if it U. (cid:9)
`on rust: (I filsingfors?: on centrally
`marrow reaction. (will I. 1,1,1,1. in (cid:9)
`" .
` 1)°1:1c.
`Discussion: (cid:9)
`, I (Mtl LINO (cid:9) ...................
`IN 1 17•.1 (cid:9)
`48. Put t. IvimisLN and \ (cid:9)
`(1:111)C1111;11,409: (:11%e of
`I jemochrotmitosis diagnosed by liver biopsy ....................
`Discussion: 1101.1,01.1., Josi.rsos, NIEVLENOBACJI (cid:9)
`.........
`I (cid:9)
`.11). I f. (cid:9)
`lekingforsi Contribution to our knowledge On the
`iocali .;11 jolt of the formative centres of blood proteins,"Id. in Nord.
`Med. nr. (cid:9)
`1 ...1 II, 11117, p. 857)
`
`Discussion: Itr. (cid:9)
`............................................
`
`343
`343
`
`344
`346
`
`350
`350
`
`Hell'
`51). Motivss 1's ,:l I: it .openhagent: The. Serum f ilucosamine wills (cid:9)
`lar Regard In it ,, significance in Connection with the Origin of Anty-
`ioid (cid:9) I ieposi P•. (cid:9)
`......................................
`Discussion: (cid:9)
`......................................
`51. i',I.sNAlt ALsaai, (Colmliagenr, .\11 oittbre;
`Discussion:
`ll g1111 (cid:9)
`(N)‘1' F.1‘11,;111ti, ‘
`i'sonA. (cid:9)
` I Vil'•.1
`"11111" non. LIRIPWALL, NILL141:N, 1<AI.1 (cid:9)
`r, SALVLSEN, ALsayn
`52. P. \VA'... (0.1o): The conr..• of hepatic ell I 11("A ................
`Neils`. I'll (cid:9)
`11111' (cid:9)
`s-lAM
`
`53. Mol;IA S It (cid:9)
`i(,opcimagen): On variations in the frequency
`of acute hepatitis .............................
`
`, 5
`
`351
`356
`357
`
`374
`376
`384
`
`386
`
`:390
`390
`
`
`
`4(14
`
`51. ,1, 1,ansIANN (Gothenburg): The Thymol lest, a new method for
`(cid:9) with
`
`judging liver function and Its diagnostic merits as compared
`the citric achlphosphatas respectively
`the
`I
`.. (cid:9)
`\l ill 11111)1. ill 'HIP
`—"Lengracht (cid:9) returns ill (cid:9)
`Discuss/ow 1. \ (cid:9)
`ALWALI., 01.111A(iEN, 1.1,I1MANN
`55. '.11001;Ns it ion .11,,,I. (copenliagen): Serum protein variations In the
` 392
`course of chronic hepatitis (cid:9)
`wEsiimoRKN,I1Jolos1.1101.• • • • (cid:9)
`308
`Discussion: 1.t1viniti1,m, I: (cid:9)
`awl FLEMMItai itnAsclior ((.open-
`56, Mmil.N.; II tonNEis()E, CLAI;ti (cid:9)
`hagen): Colloid osmol lc pressure In Chronic 1 IepatIt
`Discussion: 11.11“11,ENWIAC/11, BING (cid:9)
`57. 1). WAN`:1:1111..11 (Copenhagen); Some experimental investigations into
`I he histopalliology of the liver at cystine and methionine deficiency 405
`WANsctiEtt (cid:9)
`Discussion: LAUEIll.01,, SCHRUMPE, (cid:9)
` 409
`58. PER I rEDIAIND (Stockholm): The appearance of acute phase protein in
`various diseases. (Pull. in \cta Med, Scand. 1917, Stipp!. 196, p. 579) 111
`Discussion: OLIIAREN, Irk:I/LUND
`59. WILLIAM I<EneroLA (I lelsingfors): On the function of purified alkaline
`phosphatase and on thymonucleinic acid as its inactivator
`Discussion: MAL1AROS, LUNDSTERN, (cid:9)
`60. 1-)ER HANSSEN (Oslo): Diabetes Mellitus in Bergen 1925--1911 (Publ.
`in Acta Med. Scand. 1946, Suppl. 1781 (cid:9)
` 116
`Discussion: EcxEnsTnii'm (cid:9)
`116
`
`I I 1
`
`112
`115
`
`61.
`
`RODEN and E. (iRII'WALL (Sodertalje): A case of severe juvenile
`diabetes with an unusual complication (cid:9)
`
` 417
`
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`stilts NUN and maybe
`Subject LIS Copyright Laws
`
`Ex. 1059 - Page 5
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`

`1.X
`
`62. E. LuNiiEno, Stockholm: On acidosis in hypoglycaemia. (Publ. in
`Svenska Lakartidningen, h. 45, 19-16) (cid:9)
` 423
` 423
`Discussion: \VARSIING-LARSEN, LUNDBERG
`63. RAGE WARMING-LARSEN (Copenhagen): Ketone metabolism in adi-
` 424
`posity (cid:9)
`64. J. DianciiEN (Oslo): Hereditary osteoporosis. (Will be MINI. in Tid-
` 434
`sk r. f. den norske Laegeforening) (cid:9)
`65. O. HoLsTI(Helsingfors): Nephrosis and hypothyreosis. (Publ. in Acta
` 435
`Med.Scand. 1947, Suppl. 196, p. 285). (cid:9)
` 435
`Discussion: SVABTZ, BING, HOLM
`66. A. NORGAARD (Copenhagen): Chronic Polyarthritis in Denmark (cid:9) 437
`67. T. PAcKALI%:.: and S. liermist (Stockholm): The antistaphylosinic
`titre as indicator of staphylococcii infections. (Publ. in Acta Med.
` 443
`Scam!. 1947, 127, 291.)
` 443
`Discussion: SVARTZ, KALBAK
`68. ALF WESTERGREN (Stockholm): On a Complex Etiology in Polyarthri-
` 444
`tis
` 453
`Discussion: K ALnAK
`69. K. KALBAK (Copenhagen): I Iaemolytic stryptococcii antigene agglut-
`ination tests in patients suffering from chronic polyarthritis. (Publ.
` 454
`in Nord. Nled. nr. 31, 1946, p. 1997) (cid:9)
` 454
`Discussion: PACKALEN, LOESTIOM (cid:9)
`70. N. Sy/inn and II. OuinoEN (Stockholm): Electrophoretic analysis
` 456
`of proteins in articular rheumatism (cid:9)
` 464
`Discussion: HEDLUND, MAI,MROS
`71. N. SvAii71 (Stockholm): The treatment of 124 cases of ulcerative
`colitis with salazopyrine and attempts of desensibilization in
` 465
`cases of hypersensitiveness to sulfa (cid:9)
`Discussion: .14)sLitioN, KALLNER, INGVAR, SVARTZ, WESTERGREN (cid:9) 471
`72. Enik Tntnn (Gentofte): Treatment of ulcerative colitis with plithalyl-
` 473
`sulpha t hiazole (cid:9)
` 478
`Discussion: HoLsTi, SVARTZ, TRIER
`73. K. LuNDHAux and 0. MAALOE (Copenhagen): Investigation into the
`mecanism of fat resorption. (Not submitted for publication) (cid:9)
` 480
`74. H. Hovli (Holstebro): An examination of different kinds of foods
`with regard to their power of producing dyspeptic symptoms (cid:9) 481
`75. Esiihs KIRK and A. V. MoLLEn (Holstebro): Investigations on the
`amount and composition of flatus in normal individuals before and
` 488
`after ingestion of lactose and cow's milk (cid:9)
` 191
`Discussion: WARBURG, KIRK, NOROAARD, KIRK
`76. B. hum (Stockholm): Studies in gastric secretion with an improved
`histamine test. (Publ. in Acta Med. Scand. 1947, Suppl. 196, p.
` 492
`322)
`77. JOHN IL TOMENIUS (Stockholm): The cytologic examination of the
` 493
`gastric juice and mucus (cid:9)
` 503
`Discussion: InnE, LAGEROF, TOMENIUS, LUNDBAEK
`
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`at the NLM and may be
`Subject US Copyright Laws
`
`Ex. 1059 - Page 6
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`

`

`in contents of gastric jour.
`78. P. BRUMMI.It I I 'll`fil)on.j): On the l ime
`(Not submitted for publication) '''''''''''''''''''''
`(cid:9) 11
`e°
` C. 6°Am l(:°Iwn11 .444•11 ): Protein and follicilliii injections as ir
`It
`ment for gastric and 4111°11.11,i ul ce r w ith 4..111 i ol. iNot %11httlittetl
`• • .'
`• .. (cid:9)
`• • (cid:9)
`''''''' (cid:9) .... (cid:9)
`for publication)
`Mo. Etna: LAYMAN (Stockholm): I lifi kat bons 111)(1 tl0\1114e Of inet lI N' i Nek)1)°111'
`..,
`............................................... • • • •
`'nine (cid:9)
` clinicalttelintill:,
`Ml. II. LA(IERI.4ii, (SI(Ickhoitn.):The •tynitnIlillitiliogy 311ll
`• it,
`" of chronic 1),111cr• dill.. 4 Not submitted for publication). • . • .
`ti
`pathogens.t,
`,
`M. A. 1.0tIsTENsir• l'ilficklildiii): 4 in the question of the
`111)1'
`
`of the cerebrai in .111W, (Pohl. in .\ Ha \led. Scowl. 1917, S
`. • (cid:9)
`.................................... .. • • it
`1911, p. 204)) (cid:9)
`83. I IAQvIN Msi.snios (Orebro); 'I ht. smi th Af r ica n f rog Xenoptis illev ,
`as a test object in hormone analyses .............. .. ..... . • ' . (cid:9)
`....................
`DiSCIISSi0/1: ASK-I 'I.:ONES, MA1.511105 (cid:9)
`81. TII. STENSTRoM (I hilsingborg): Penicillin and Drug I.ever .. (cid:9)
`Discussion: Svnitt z. NIsi.silios (cid:9) ..................... . • • • ",th
`85. 'futon-: \ imistim (Copenhagen): Treatment of Scarlet Fever %%I . r'q'"'j
`.................................... .. • • • • • " ' . • (cid:9)
`533
`Penicillin (cid:9)
`............................ . • • • • • • ' ' (cid:9) ,
`Discos .1,41. (cid:9)
`I. :. I (cid:9) ii . (cid:9)
`. (cid:9)
`Incubation
`86. ,:r. 1.,,‘,:,,,iiirii.:IiNt:,,ri ti:::11::,,,11,,, \.n, ::,, .om A IA ( i ic isingrors ): (cid:9)
`....t.11.11.t. (cid:9)
`in epidemic in Finland in 1915 '
`Discussion, (cid:9) v ti,ii1N , I I I.: INN BLItii (cid:9)
`' ' ' ... :. .... li.
`87. M1.it rti Ill,1)1Z and Pot 4. Timii.i a ••• (Copenhagen): Nervous '''''''')
`.
`.,
`................... . • • • • (cid:9)
`cat Ions in (cid:9)
`..
`I 41)11111Pd i (cid:9)
`88. Olmi• ( 11.ssors and CI n 1 VI Ha •.. 44 ilithenburg): 'tumour (IllOolle't
`
`510
`
`511
`
`511
`515
`51i
`521
`
`Z3400
`
`511
`
`511
`
`.
`
`. . (cid:9) ............... (cid:9)
`
`front !Actual exudates ................................. .
`89. P. A. OwliEN (0s14): Parahaeinophilia, a haemorrliagic diatheses (loot,
`to the 1111.151118 of a coagulation agent hitherto unknown. (Publ.
`.:
`The Lancet 1916) ................................ . ..... • ' (cid:9)
`etw te n s
`ONN ((•,011CIII1AUCII): Relations bp at i
`941. Om.: Ciiiii .1 F.N!4EN 1111(I CARL Si:
`skin rear l ions and Provocatory Inhalation tests in asthmatic
`..... r
`l' ALLNER, SICA'EliS, EGGIATI NI(n.i.t.ii, Stissli (cid:9)
`
`Discussion:Discussion:
`SG/
`91. limn, .111111,1N-1 ) ANNULI:I (Stockholm): About the occurrence' n
`. . .
`.............
`....
`various forms of pollen allergy In Sweden (cid:9)
`92. SixTEN 1 ALLN Elt (Stockholm): Sulfa treatment in cases of bronchitic
`.......................................... •
`asthma (cid:9)
`Discussion: SVARTZ, l<ALLNEII, 1101,511, LANDAI ", l'. ALLN Ell ..... •
` atypical pneu-
`93. Iliosts STENovisir (1Ialsingborg): About acute primary
` .. • • • • • "
`monia.............................................
`, I.'"'1 11' 1...'
`Discussion: VON ROSEN, BING, FRISK, HOLSTI, KALLNElt
`94. GosrA ROOTH (Lund): Nebulization a new treatment for suppnrative
`.............................
`deseases of the bronchial tree (cid:9)
`' Discussion: NIALNIROS...................................... • •
`95. &rum?. HELANDER (Stockholm): Fluorescence microscopy ...... • •
`96. EINAR RIERRING (Copenhagen): Standardization of Iliernometers • •
`Discussion: SILWER, LEHMANN, 13IERRING, WARBURG • ..... •
`
`554
`
`555
`560
`
`5113
`
`571
`581
`
`58b
`591
`
`593
`590
`600
`601
`613
`
`This material was copied
`at the KM and maybe
`
`Ex. 1059 - Page 7
`
`(cid:9)
`(cid:9)
`(cid:9)
`(cid:9)
`(cid:9)
`(cid:9)
`(cid:9)
`(cid:9)
`(cid:9)
`(cid:9)
`

`

`71. N. Svartz.
`
`The treatment of 124 cases of ulcerative colitis
`with salazopyrine and attempts of desensibili-
`zat ion in cases of hypersensitiveness to sulfa.
`
`On various occasions, I have been asked concerning the num-
`ber of cases Of ulcerative colitis and polvarthritis treated with
`salazopyrinei at knrolinskit Sjnkhuset in Stockholm and the results
`obtained front this treatment. I have not been in a position to
`make any definite statement earlier. In the following, an account
`Will lie given of the colitis nIcerosa-material front the period 19.11)-
`1911
`Iniring this particular period, 121 patients were treated with
`sala/opyritte (salicvlazosulfapyridinc). As may be seen front the
`table below, 7i of the 121 cases became completely free from sub-
`jective svnil,lone during the first period of treatment and .11 were
`Improved. No effect was observed in 8 cases. (The
`
`TABLE 1.
`Results of treatment with salazopyrine in cases of ulcerative colitis,
`
`-C E.
`0
`'6%
`
`-,,, , . -,
`11
`
` ' .. .
`..,- (cid:9) E
`o 4.,
`I" -
`c
`',..
`
`A
`
`"A _ -
`'"
`_
`
`o
`:*
`E
`E
`.^.
`=
`
`•C
`;...,a.,
`'Total number of
`-4:: co
` A c.. co
`unimproved
`
`= eld 0 . (cid:9) 1. (cid:9) 4..
`ta. 6,
`i.'
`E (cid:9)
`-- (cid:9)
`0 0 (cid:9)
`CE:
`..... . (cid:9) _ (cid:9)
`..., (cid:9) ,,,
`.•
`(cid:9) o
`,i-, (cid:9)
`•-•
`.1. (cid:9) "
`
`.
`
`E o c.3 (cid:9)
`
`. -..
`.- z
`-.7.1 (cid:9)
`•
`Tr -5
`1..) (cid:9) C.)
`
`E (cid:9) • tn o .
`
`.-: 1:1
`,...
`- 0
`el 4
`...
`
`4.1 .8
`
`c.,
`t, .t. (cid:9) 4
`27 0.
`0 (cid:9)
`..1.,
`, -
`
`;-•
`,.. (cid:9)
`.... (cid:9) ,
`a., Ed E..
`1.,
`
`75
`
`41
`
`8
`
`57
`
`49
`
`8
`
`3
`
`5
`
`Salazopyrine is an aso-compound between salicylic acid and sulfapyri-
`dine, which compound was prepared in collaboration with E. ASKEL8F
`and 11. WILLsraJosr, A.B. Pharmasla, Stockholm.
`
`This material wascopied
`atthe NLM arid may be
`
`Ex. 1059 - Page 8
`
`(cid:9)
`(cid:9)
`

`

`466
`
`cases where treatment had to be discontinued after oPlv a few
`owing to hypersensitiveness, have not. been included in the ealcula-
`[loos.)
`Fig. 1 shows that a great number of relapses occurrent, i.e. in 57
`patients. 49 of these cases either improved greatly or recovered at.
`renewed treatment with the sane' prinini ioR. The large frequency
`of relapses is mainly due to tl,e fact that treatment has often
`been interrupted at too early a :,1:1! (cid:9)
`owing to lack of sufficient
`experience. Even if the patient . should appear fully restored, the
`medication should, as a rule. lie continued for three months or
`more. The definite figure of complete recovery cannot, as yet, be
`fixed since the period of observation has ill several instances heen
`too short. As regards the total Rundwr of urtimproved cascs, refe-
`rence may he had to Fig. 1.
`
`TABLE 2.
`Acerativc colitis; Ileslilts of treatment (cid:9)
`
`ith salazopyrine.
`
`Ntit0. of treated pat.
`
`I )e;01 front ot fuer di.,e;1 1.
`
`I tetnaining 11010. of 1.11. (cid:9)
`
`•nintpro•o'd
`
`121
`
`5
`
`119
`
`11
`
`
`
`
`
`co11 (cid:9)
`
`aid impil./ved and recr,vered
`
`108 (90"„)
`
`Fig. 2 gives a brief survey 4,1 the results, showing that approxim-
`ately 90 per cent of the clientele were either greatly improved or
`fully restored. Further, it. may he noted from Figs. 1 and 2 that
`5 of the patients died from a disease other than, ulcerative colitis.
`
`'1'11111,1.
`'Hue death ea11,1",, iu Ili'
`
`‘• (cid:9)
`
`‘%ho died.
`
`Num. of cases
`3
`
`Cancer coli
`Tuberculosis pulm. (cid:9)
`
`Pulmonary embolism (cid:9)
`
`Cont. ulc. with sepsis (cid:9)
`
`Colit. ulc. with sepsis (short treatment)
`Colit. ulc. with peritoneal abscess and sepsis (treated at
`
`hospital only for 8 days)
`
`
`
`This material was copied
`at the NLM and may be
`Subject US Copyright Laws
`
`Ex. 1059 - Page 9
`
`(cid:9)
`(cid:9)
`(cid:9)
`(cid:9)
`(cid:9)
`

`

`467
`
`Fig. 3 accounts for the death causes in these cases. Not less than
`three of these patients died from cancer soli. Two of them were
`quite young hut had suffered front ulcerative colitis for a long
`time prior to the manifestation of cancer. lit all likelihood, the
`chronic state of irritation in the colon may have paved the way
`for the cancer in these instances.
`When judging the results of treatment in the present material,
`it should be remendnxed that a largo moldier of cases are included
`which were admitted to the clinic at an advanced state of the
`disease, not withstanding prolonged treatment.
`In cases where ii continued hypersensitiveness or an unsatis-
`factory effect occurred with the use of salazopyrine, salicylazothia-
`zole (salazothiazole) or other preparations were tried instead.
`Salazothiazole generally gives less satisfactory results than does
`salazopyrine. Sulfaguanidine and sulfadigesine also have a less
`good effect. .\s regards italylsulfathiazole (sulftaly1), it is still too
`early to draw any conclusion,. This preparation does not, at any
`rate, seem to offer helps y.•.ulls than the azo compounds. Sillfa-
`gilaRidilo., sulfadigesine, as v,•H (cid:9)
`sulftalvl are, as known, usually
`applied in very large 21-hour-doses, i.e. approximately 36 tablets
`daily, while salazopyrine is administered in doses of rarely more
`than 12 tablets, i.e. not more than a third. As a matter of course,
`this must he laken into consideration When comparing the. effects.
`Lately, :,matter loses of sulftalyl have been initialed. The results
`remain, to he , eee..
`Ill;LANI>r;n '5 investigations have shed new light on the activity
`of salazopyrine and salazothiazole. About Iwo years ago, I requ-
`ested th;,1 (cid:9)
`who was at the time studying the effect of
`prontosil by (cid:9)
`of fluorescence microscopy, should also per-
`form experiments with the forementioncd preparations. Accord-
`Hly, it was found that these drugs, like prontosil and other acid
`azo compounds, had a special affinity to connective tissue and
`elastic tissue, in particular. In these tissues, deposits are formed
`of the drugs which arc gradually disintergrated on the spot.
`Thus, aminosalicvlic acid awl sulfapyridine derived from salazo-
`pyrinc. In vii w of the fact that the inflammatory clanger at ulce-
`rative it,lili, are localized to the subepithehal connective tissue,
`the rational way i naturally to use preparations which have a spe-
`cial affinity t o connective tissue. This applies, as already mentioned,
`
`This material was copied
`at the NLM and may be
`Subject US Copyright Laws
`
`Ex. 1059 - Page 10
`
`

`

`468
`
`Else B., '27 years old.
`
`Day
`
`3/8
`
`2 3
`
`7 8 19 /0 // /2
`
`/9 /4 , /5 /61--/71 /8 /9120
`
`au
`
`an
`
`39.
`
`:yr
`
`U)
`
`36'
`
`Arta( ing
`
`Urin
`
`S.R
`
`Day
`
`tr.
`
`rS
`
`— X= a
`
`22 23
`
`24
`
`25 26 27
`
`Sle.for
`
`66
`
`28
`r:/
`
`29 30 0 2
`,;(.rx
`
`•,0
`
`5- I
`
`7 8 9
`
`/0
`
`on,Mr/I .o,//N NIIN.NUNanN rrr..1.411.101.1
`
`, (cid:9)
`
`•
`
`fAl
`
`• --;=
`
`ll
`
`38
`
`/
`
`32,
`
`Fig. 4. Period, of ulcerativi. rolili, for iii• p.1.1 (cid:9)
`Front Ilit Iran .vi•i
`;tiIt (cid:9)
`
`Frei' from (cid:9)
`
`%.•.11
`
`ill,.
`
`Evacuid ion: (cid:9)
`
`I lorisoid (cid:9)
`Sloping (cid:9)
`
`V ,1111';11 (cid:9)
`
`lint' (cid:9)
`
`,I•
`
`.011r1
`
`,t111(1
`
`ordinary sullapre-
`to said/00.611e and salazothiazole (cid:9)
`parat ions are diffusely distributed jn, the tissues.
`(cid:9) Very rapid.
`The effect of the azo-preparations is some
`days. In other
`The diarrhoea may cease as soon as after (cid:9)
`eases, the effect may not set. ift until after prolonged treatment.
`Figs. •1-----15 (only Figs. 1- --7 being reproduced here for reasons
`of space) illustrate the different rapidity in the effect obtained by
`the salazopyrine treatment on the diarrhoeic condition. As previ-
`ously mentioned, it is of vital importance that the cure is not
`discontinued too soon. Several of our patients used the prepara-
`tion for months (at times for 2-3 years). generally taking quite
`small doses as, for instance, 1/2 g 2-3 times daily. 'Ile initial dose
`
`This material wasropied
`atthe NLM and may be
`Subject US Copyright Laws
`
`Ex. 1059 - Page 11
`
`

`

`Allan N., 13 ear,
`
`oft 18/, 2i13o 3/ (cid:9)
`3 (cid:9)
`I. Azopyirik
`, 011101. ttttt 10/1101. (cid:9)
`00 (cid:9)
`
`5 ' 6 1 7 8 y I/O // /2I /3 /4 /S' /6 /7
`; (cid:9)
`' (cid:9)
`•
`ttttttt 111101.1011,1111411111111 *Ills li CHIII .11111. ttttttt Ol0011111111"10
`
`,,,,, (cid:9)
`
`169
`
`i
`•
`/ / / / / /x
`
`/4‘
`
`Arforing
`
`IHN
`
`/ /
`
`/
`
`/
`.1i
`
`5. R. (cid:9)
`/7
`2.3 ! 6 2 7 20
`Dft /8A /f 2 .0 2/ 2 .2 2 3
`l',47C0111./.rn .rri A 4
`
`41:1
`
`•Z
`
`0 V.
`
`
`
`, .'
`
`4 A (cid:9)
`
`n
`!'>-\:',,-- l'.._.
`••
`
`1 (cid:9) I. J._ /. 1 /
`
`i/ (cid:9)
`
`.1 1/
`
`
`
`
`
` -- - (cid:9) —
`
`/7., (cid:9)
`
`1
`
`Fig. 5. Ulcer:lave colitis for the past 4 years.
`fioiagelk (cid:9)
`;In (cid:9)
`the 5% ho le of the colon.
`l'ree from :objective ,vinptoins after being 1.1ken ;11a7opyrinc.
`10(0 11 11 •'".. 11111.I , 0.1• (cid:9)
`\Oh (cid:9)
`1 17. opyrine•
`
`after
`
`rule, I, h 5 , Tv I m.eikk. -four Lours. \\ Len the diarrh oea has
`ceased and the ri ( 101 mucous membraite Las improved, the (lose is
`(1,•ereased cold iPtiousl'.
`
`NOWada) S, I•X (cid:9)
`
`t•X )1111•I., 'I' has been gained regarding the
`difficulty of applying -Aida - preparations in cases of hypersensitive-
`ness with fever and exanthrna. Calcium and ephedrine. therapeu-
`tics may cause a reduction in the sensibility. This, however, only
`takes place in a comparatively few eases. For the past 3-1 years,
`I have been carrying out desensibilization experiments per os at
`probably the first to have
`Karolinska SjukLuset. (cid:9)
`pointed out the possibilit (cid:9)
`ot such desensibilization.
`In tie case of ex:mil:cilia :IR.d fever, at for instance salazopyrine
`tLe (low is iluniediatelv reduced. only 1 1 of a tablet
`
`This material was copied
`at the NLF1.1 and maybe
`Subject US Copyright Laws
`
`Ex. 1059 - Page 12
`
`(cid:9)
`

`

`470
`
`Erik if., 15 years old
`
`,..D°1.:,,. 41/128
`
`/_,..7..,Z8..._
`
`40
`
`NA
`
`,
`., (cid:9)
`•
`-
`
`
`'
`—7-.4%4 z
`
`.c.re
`
`rzr.,.-.?
`
`120
`
`II'"?
`
`/9 2012/ 22
`
`29
`
`241-25 1 26
`
`28 '-293019 /r/ 24,- 2. 9.--.
`
`1 4.
`
`
`27
`(Zs x 4
`,,,,,,...,77,7771
`
`,771777.7i7m,,,,
`S
`/174r0 jeky/i/ii
`
`
`.111-Arliz.tf,
`IT7/11,7711/177777.171, - If
`
`
`
`.
`
`- -
`
`E-' (cid:9) ' - //
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`
`/ / / /
`
`/// ////
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`///
`
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`- 0 / . /1
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`
`/ / / ///
`
`_ _______
`/7
`
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`
`8 9
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`
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`/8
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`
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`/9 20 2/ 22 23 24 2.5
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`of
`
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`:
`41
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`I' A ."--,
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`120
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`171
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`50
`
`354
`
`"4440
`Orin
`
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`ill iii
`
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`
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`ill
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`&AI
`
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`iii
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`27 28 29 30 1/4
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`25
`1
`4,
`1`2*- 2777"9"zi-Ii!».trzit.74,,t,,,,,f,,,,-77-1.77>AN,7,r,,,,A.-/),
`
`5.R.
`
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`
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`Udn
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`
`1/ /// ///
`0
`
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`
`///
`
`/// ///
`
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`
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`///
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`
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`
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`—'
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`
`/1/
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`li
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`//
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`I
`--. -
`
`/5 _
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`
`Fig. 6. Ulcerative colitis for tie past 4 years. At times improved.
`Röntgen changes: The whole colon (cid:9)
`terminal ileitis.
`Free from subjective symptoms after being given salazopyrine.
`
`being administered 2-3 times daily for the next 8-10 days. In this
`way desensibilization may be achieved in several cases. Thus, the
`dose may then again be increased without involving exanthema, etc.
`This increase must, nevertheless, be performed very slowly.
`The same method of desensibilization has been employed with
`
`This material was copied
`at the NLM acrd' may be
`Subject US Copyright Laws
`
`Ex. 1059 - Page 13
`
`

`

`Margareta A., 37 years old
`
`171
`
`Fig 7. Viceratlye colitis for the past 7 months.
`Millen changes: The whole of the colon.
`Free front subjective symiomns "fir' Iwing given
`tiv,ae-e, to s;11azopyrni).
`
`latothiazole ihypersensi-
`
`regard to other forms of Itypersciisitiveitcss to me(licametits, e.g.,
`at inethylthiottracil 1m:die:thou. .\lso iit those cases, it has often
`been found possible. to 1.00 ittuc thr treat melt( later without eatisiikg,
`exanthema. 44c.
`
`Josef 80 .
`
`Discussion .
`
`K. (cid:9)
`
`:
`should like to touch briefly oti the question of local treatment of
`1400.1 a result,
`ulcerative colitis. AS a Nile the perorat treatment gives (cid:9)
`that no other is required. But local treatment is iinlie.ate I on l‘vo different
`a rest
`occasions. 1) \\III' changes confinel to the reetum, whither it (cid:9)
`vmdition after a peroral treatment or an early case nt iiteeratiou; 2 ) in
`8(!v,..r., eases of the disease with Changes exteruling along the entire intes-
`tine. In these cases we earlier 11.0,1 to give enemas of collargal. We have
`
`32
`
`This material wascopied
`at the NLM and may be
`Subject US Copyright Laws
`
`Ex. 1059 - Page 14
`
`

`

`.472
`
`agar-agar, t' which a water-soluble
`now changed over to 'Tema %%it ti (cid:9)
`n ifa rnidin,•, ha-. been added to I--2 %. The enema
`chemotherapeutic, e.g.
`takes the pasty mass
`and Itot patient
`is given slowly at .10_ 41° (cid:9)
`without reacting. .\ bout 200 cm , :ire enough to fill the ampulla; 400 ein3
`brings one up to the left flexura, and at 800 cm' the entire eo.hoi is
`i added
`on the X-ray if a little (cid:9)
`usually f111..,1 up, as can be (cid:9)
`l 11 and
`to the in,0- (cid:9) This enema, which lightly dr;teick the v.hoh (cid:9)
`t with the en tire Wined .11 .'14111 (cid:9)
`thus come, into con (cid:9)
`•.,.hieh naturally fa\our, the 11...iiing (cid:9)
`motility of the int , (cid:9)
`infection. 1 he mere adiumi ;11.;0 h•011001 the ;war-aizar enema Wit hifil
`addition of the chemie;11 has ;1 heil••f00.1,01.•eti0011 a nd 1110
`v•ere able
`by the sulfa-drug. N1',. have had ca .• • of ulcerative eohli (cid:9)
`a period of up
`kind for e:eral day- (cid:9)
`enema of (cid:9)
`to retain (cid:9