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.)
quences of viral action, while in the background of leukoencephalitides he suspected a uniform etiology, in which constitutional and immunological factors play an important role. Pette had a genuine interest in the study of viral spread within the nervous system, the elementary affinity of certain viruses to definite areas of the nervous system, and in the pathogenesis of the most dangerous viral disease of the era, the infectious palsy of children, the poliomyelitis. The Pette family remembers vividly that the young Környey, arriving in Magdeburg, was very much surprised that the 14-year-older Pette took him as co-worker, although he had at that time only a single publication on encephalitides 1 . Although Környey did not stay long in Magdeburg, his short stay enabled him to complete an interesting case report. Together with Pette he described the cases of two patients deceased in Landry paralysis (Pette and Környey, 1930). Albumino-cytological dissociation was characteristic of both these cases, and at histological examination an inflammation of the spinal ganglia and roots was in the foreground. They pointed to the similarities of these cases with those described by Guillain and Barré and assumed viral infection as an etiological agent. They emphasized that in such cases some sort of acute infection precedes the presentation of neurological signs. In 1930 Pette was invited to head the neurological department of the St. Georg Hospital in Hamburg. Pette directed this department until 1934, when he became the successor of Max Nonne on the chair of neurology at the University of Hamburg. Környey accompanied Pette to Hamburg, where the St. Georg Hospital became the scene of their almost 5-year-long, most successful cooperation. Pette and Környey, together with Demnie, at that time at the University Clinic of Neurology in Hamburg-Eppendorf, performed widespread experimental studies on monkeys to investigate the pathogenesis of poliomyelitis (Pette, Demme and Környey, 1932). In the 1930ies human poliomyelitis could only be transmitted to monkeys, therefore, it was conceivable that the objects of these expensive experiments had been examined most intensely both clinically and pathologically. In the report comprising 127 pages they described minutely the characteristics of the inflammatory infiltrates and of the neuronal damage in various phases of the disease, with special emphasis on the paralytic phase. They applied intracerebral, intraneural, nasal, gastro-intestinal and intravenous inoculations on the monkeys and studied the dynamics of the spread of infection in various postinfectious phases. They established that in the early phase of the disease neural structures situated the nearest to the site of inoculation succumbed predilectionally to the infectious process, in the later phases, however, the extension of the process was getting progressively independent from the portal of virus entry. Thus, the extension of the infectious process is determined by two factors: first, by the affinity of the virus towards definite areas of the nervous system, second, by the length of time elapsed from the infection, denoted in this context as the time factor. The extension of the poliomyelitic process is characterized by a definite systemselectivity ("Systemelektivität"). The motoneurons of the ventral horn of the spinal cord suffer most severely, notably in the lumbar segments more prominently than in the cervical ones. The affinity towards the nuclei of the motor cranial nerves is less pronounced , but the vestibular nuclei are conspicuously damaged. In the cerebral cortex the somatomotor area, especially its Illrd and Vth layers are damaged with strongly pronounced selectivity. 1 Dr. Nikolaja Prosenc, personal communication.
