Kapronczay Károly szerk.: Orvostörténeti Közlemények 182-185. (Budapest, 2003)

TANULMÁNYOK - ARTICLES - GOSZTONYI, Georg: Stephan Környey's contribution to the study of encephalitides. (Környey István hozzájárulása az. agyhártyagyulladás kutatásához.)

STEPHEN KÖRNYEY "S CONTRIBUTION TO THE STUDY OF ENCEPHALITIDES GEORG GOSZTONYI A considerable part of Környey's scientific oeuvre, more than one quarter of his publications, deals with the inflammatory diseases of the nervous system. His attention turned already at the early phase of his carrier to the encephalitides. He preserved this orientation throughout his entire professional life, although in the middle of his career the anoxic-vasal disturbances of the nervous system, the degenerative nervous disorders and neurosurgical topics advanced in the forefront of his scientific interest. His first study on encephalitides was carried out in 1930 in Budapest, in the Brain Research Institute of Karl Schaffer (Környey 1930). Before that, he had already published eight studies dealing with other topics. The clinical symptomatology of the late consequences of encephalitis lethargica had already been known at that time, however, the study of the morphological substrate of these clinical signs had left much to be defined. Környey described in detail the severe, selective neuronal breakdown in the substantia nigra, and the less pronounced neuronal damage in the pallidum and striatum. He emphasized the selective character of the damage and drew a parallel between the elementary affinity of the agent of von Economo's encephalitis towards the substantia nigra, and of the agent of the poliomyelitis towards the ventral horn motor neurons of the spinal cord. To explain the retarded appearance of neuronal damage Környey raises - following von Economo - the concept of virus persistence. He believed, however, that the delayed neuronal degeneration was perhaps more likely the result of a damage striking severely the vitality of the neuron in the course of the acute disease, which manifests itself only with a delay of several years. Based on the correlation of clinical symptoms and the anatomical findings he concluded that the Parkinsonian rigor was the consequence of the lesion to the pallidum, while the akinetic-bradykinetic syndrome that of the lesion to the substantia nigra. Környeys's study on the "lecithinoid" breakdown products (Környey 1929), written in Schaffens Brain Research Institute as well, became the source of a certain tension between professor Schaffer and him that was described in detail in the Környey biography of F.T. Mérei (1994). Környey had to look for a new place of work, and his choice fell - most fortunately - on the institution led by Heinrich Fette in Magdeburg. At the beginning of the 1930ies Pette's neurological department in Magdeburg was a most important and active centre of the European encephalitis research. With excellent clairvoyance Pette had just separated the polioencephalitides from the leukoencephalitides ("akut entzündliche Erkrankungen vornehmlich der grauen Substanz; akut entzündliche Erkrankungen vornehmlich der weißen Substanz", Pette, 1929). Pette regarded the former as direct conse-