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.)

concise reviews in this period, in which he laid down his pathogenetic considerations and which were published in highly respected German periodicals. In his review on the primary neurotropic human infectious diseases he summarized the knowledge on encephalitides of the 1930ies. He laid special emphasis on the Japanese encephalitis, the St. Louis encephalitis in the USA, the Australian x-disease and the rare human cases of louping ill. He called attention to the mutual features of these diseases and postulated that they formed a specific nosological group. The review encompassed important pathogenetic considerations as well. He treated the mechanism of neural spread of viruses, the entry and passage of viruses along the olfactory nerve into the CNS, and the significance of the principle of special neurotropism (Pette) in the extension of the encephalitic process. He advocated the serum therapy (passive immunisation) of poliomyelitis and reviewed the early immunisation attempts. In his review on acute inflammatory diseases of the nervous system (Környey, 1941a), he complemented the topics treated in his previous comprehensive survey article with new data of the literature. He discussed emphatically the pathogenetic questions of poliomyelitis and reported on European cases of encephalitis showing similarities to the symptomatology of the Japanese encephalitis. These European cases had been denoted as panencephalomyelitis by Pette and Döring (1939; 1942). Környey published another review in 1941 entitled "Encephalitis and myelitis" (Környey, 1941b). In this review, written in Hungarian, he treated in detail the concept of inflammation, described the different types of encephalitides, their symptomatology, furthermore, the epidemiology and pathogenesis of encephalitides. This review offered up-todate, concise information on the problems of encephalitides for the Hungarian pathologists, neurologists and general practitioners. Among his review articles the most extensive appeared in the Ergebnisse der Pathologie (Környey, 1943) and treated in 88 pages the acute, non-specific, non-purulent inflammatory diseases of the human nervous system. This review, with the character of a monograph, comprising 397 references and supported by Prince Pál Esterházy was written by Környey during his activity in Kolozsvár. This study offered a modern, concise synopsis of the problems of encephalitides. Following an extensive survey of the concept of inflammation he reviewed the various types of encephalitides. After the treatise of the Japanese encephalitis (B-encephalitis) he described similar diseases occurring on the American continent, as well as sporadic cases in Germany, denoted as panencephalomyelitis (Pette, 1938; Pette and Döring, 1939). In connection to the latter, Környey described the case of an 8-year-old Rumanian girl, Anna Rusu, observed in Transylvania. Her nervous disease had led to her death in 6 months and proved to be an encephalitis. Lympho-plasmocytic infiltrations were present in both the gray and white matter. In retrospect, this description represents the first documented case of subacute sclerotizing panencephalitis (SSPE) in the Carpathian basin. This review surveyed the development of the concept of the general and special neurotropism (Pette, 1929) and laid special emphasis on the phenomenon of gangliocytotropism that denotes the affinity of definite varieties of viruses towards specific neuronal types. The principle, defined earlier, according to which the extension of the pathological alterations in the phase of the full development of the encephalitic process is independent of the portal of entry of the virus, needed a certain limitation. More importance had to be attributed to