CYSTOMETRY IN SYPHILITIC PATIENTS

1 st REPORT THE RESULT OF EACH PERIOD

Abstract

Putting together various reports of cystometry on syphilis, which connected with sensibility and motility, I found only the cases of dorsalis tabes.
Then I examined systematically each period of syphilis on 120 cases, and also closely examind the influence of antisyphilitic therapy on 40 cases of them. From the view of spinal fluid, skin, schleim, lymphatic, ophthalmofund, internal ears, aorta, Takada's test of serum, cystoscopic and neurologic inspections, I studied to solve this problem.
Method of cystometry
For the purpose of measuring the intravesical pressure a catheter inserted in bladder, a syringe and mercury manometer are conected with a three-way valve by a rubbertube, then sterilized water is introduced intermittently. In interpreting the cystometrogram following 4 points were taken into consideration:
(1) the minium desire to void, (2) the, maximum desire to void, (3) the maximum voluntary pressure, (4) the character of tonus curve.
The result of each period
The result in 31 cases (25.8%) out of whole 120 cases showed the abnormal cystometrograms and the abnormal frequencies increased with the progress of late stage. The following are the results of each period.
1) Recent syphilis:
In primary 5 cases all were normal. In secondary 21 cases neurogenic hypertony 3 cases, neurogenic hypotony 1 case, non-neurogenic hypertony 1 cases, and other cases showed normal cystometrograms. In tertiary 8 cases: neurogenic hypotony 2, neurogenic hypertony 1, and others normal.
2) Latent syphilis:
In early 17 cases: neurogenic hypertony 1 cases, non-neurogenic hypertony 1 case, and others showed normal.
In late 24 case: neurogenic hyoertony 2, neurogenic hypotony 3, non-neurogenic hypertony 2, and others normal. Above mentioned non-neurogenic cases were originated in the cystitis, but in other neurogenic cases were discovered the following results: neurogenic hypertony in 2nd stage and early latent syphilis was caused on Jarisch-Herxheimer's reaction or on the neurorelapse, but neurogenic hypotony in the same stage was caused on latent syphilitic cerebro-spinal meningitis, and judging from the results of 1), 2) and the following 3) results, neurogenic hypotony in the tertiary syphilis and in the late latent syphilis was preclinical symptom of tabes dorsalis and neurogenic hypertony was pre-clinical symptom of dementia paralytics.
3) Meta-syphilis and congenital syphilis:
Neurogenic hypotony was showed in 5 cases out of 6 tabes dorsalis, neurogenic hypertony in 15 cases out of 20 dementia paralytica and neurogenic hypertony in 3 cases out of 4 taboparalyse.
In congenital syphilis, 1 case showed neurogenic hypotony, which was pre-clinical symptom of juvenile tabes dorsalis, and others showed the normal cystometrogram.