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aspect of changes in electrical potential along thecourse of the vessel. By means of high amplificationhe has been able to demonstrate diphasic followedby monophasic currents in the arteries of animalswith each pulse-wave. He has repeated theseobservations on human subjects with the same

results, and claims that these changes are evidenceof muscular contraction, since control experimentson dead arteries and elastic tubes were absolutelynegative. This work suggests that each pulse-waveis the stimulus to an active contraction of the arterialwall. In veins, also, he found electrical changes,but here of such large amplitude that it was possibleto record them without amplification. The featureof these " venous electrograms " is the fact thatthe " contractions " are wholly irregular and ceaseafter occlusion of the proximal end of the vein.Whatever may be the correct interpretation of thesefindings they form an interesting contribution to thediscussion whether or not an active role should beascribed to the arteries and veins.

SYMPATHETIC GANGLION LESIONS IN

SCLERODERMA.

THE aetiology of scleroderma is still much disputed,but facts are accumulating to support the view thatimplication of the sympathetic nervous system isassociated with, or possibly the cause of, the disease.Dr. Geoffrey Blake describes a case of a womanof 30, who had attended hospital in 1919 for symptomspointing to Raynaud’s disease. This is not remarkable,for in the earlier stages of the sclerosing conditionthe extremities are often blue and cold, and thefinger tips and nail beds may present atrophic changes.She was not seen again until 1923, when the skinchanges had progressed and were recognised for whatthey really were, scleroderma with some degree ofleukoderma, and the emaciation often associatedwith this condition. There were, in addition, symptomspointing to spasm of the oesophagus, confirmed byX ray examination. In July, 1929, X ray examinationrevealed obstruction at the pylorus, with dilatationof both the large and small intestines with almostcomplete obstruction of the descending colon. Ileo-

sigmoidostomy was performed, but diarrhoea and

vomiting were not relieved, and a ceecostomy wasfelt to be imperative. But the symptoms were notrelieved, and the patient died on Sept. 22nd, 1929.At the autopsy, 12 hours later, sections were made ofthe skin and of portions of the endocrine glands. The

changes due to scleroderma, which had been con-firmed by a biopsy of the skin during the patient’slifetime, were again demonstrated. These includedloss and atrophy of the papill2e, excessive pigmentin the rete, dense sclerotic tissue in the dermis, withsecondary atrophy of the cutaneous appendages.There were no definite microscopic abnormalities in anyof the endocrine glands. The whole large intestineshowed an abnormal degree of dilatation, which was sopronounced as to mask hypertrophy of moderatetype. Of great interest and importance-especially ifthey are confirmed by reports on other autopsies-are the changes described in microscopic sectionsof the lower cervical sympathetic ganglion. The

ganglion cells are said to be fewer than normal, manyshow striking changes. Some are enlarged and paleand show marked loss of finer structure ; they appearto be "blown up." Others are small and shrunken,and stain deeply. Such changes have not been

1 Bull. Johns Hopkins Hosp., April, 1931, pp. 212-227.

found in a series of controls taken at the same timeafter death. Other observers have sought in vainfor such changes in the nervous system, althoughsymptoms such as facial hemiatrophy and tropho-neuroses, and the not-infrequent zonal distribution ofsclerodermic plaques, would tend to support theassociation between scleroderma and lesions in the

sympathetic nervous system. That Raynaud’ssyndrome is likely to be due to disease of this systemwould seem to follow from the results of arterial

sympathectomy, and the clinical resemblances betweenscleroderma and Raynaud’s disease in their earlystages adds weight to the possibility of a commonaetiology. ____

LEGUMINOUS CROPS AND MALARIA.

Prof. Hans Ziemann,! of Berlin, notes that underapparently similar physical conditions, and with similarmosquito prevalence, the amount of malaria may besurprisingly different. D’Herelle informs him thathe noticed in the Argentine, 20 years ago, that

leguminosae grew about the streams and swamps inthe malaria-free districts, but not in those where therewas malaria. He observes that malaria disappearedfrom some islands of Holland in 1880, when cloverfrom the south of France was sown there, and heagrees with Sir William Willcocks in ascribing thefreedom of most of Egypt from malaria to the growthof wild clover, which is absent in the Suez canal zone,in Palestine, and in Greece, where the infection is

prevalent. D’Herelle ascribes the influence of theseleguminosae to the coumarin contained in theirblossoms, which appear in the malarial (summer andautumn) season. Ziemann also quotes Krysto, of theRussian Agricultural Department, writing in theScientific American for April, who says that 35 yearsago, when he lived in the Caucasus, everyone in hisvalley had malaria except the four who had plantedbeans and lucerne around their houses ; he has seenthe same in the Southern States and in Argentina,where malaria disappeared when lucerne was sown,though mosquitoes persisted as before. It is suggestedthat when the female mosquito sucks juice from theseflowers she is either cured of her infection (as a

man by quinine), or the gametes are sterilised.These questions have yet to be studied, and Prof.Ziemann calls for experiment. He gives a list of some80 coumarin-containing plants and invites peopleliving in a malarial district to choose those that willsuit the climate, remembering they must flower

throughout the worst season of infection.

SPEECH AND VOICE.2

IN spite of numerous painstaking researches ourknowledge of the exact mechanism by which thesounds of speech are produced is still very inexact.Especially is this the case for the production of thevowel-sounds which, although the variations of move-ment involved are probably very minute, are easilydetected by the ear. The differences of voice qualitypresent a similar problem ; here personal qualityand family resemblances are very definite, so as

readily to be recognised even over the telephone,and probably depend on very small differences in theshape and structure of the producing cavities. Sir

1 Arch. f. Schiffs- u. Tropen-Hygiene, July, 1931, p. 410.2 Speech and Voice, with X Rays of English, French, German,

Italian, Spanish, Soprano, Tenor, and Baritone Subjects.By G. Oscar Russell, Ph.D., Director of Phonetics, Laboratoriesand Speech Clinic, Ohio State University. New York : TheMacmillan Company. 1931. Pp. 250. 17s.