Die Herpes simplex-Virus-Infektionen

A case of acute ascending myelitis which followed the bite of an apparently normal Macacus rhesus monkey is described. The clinical course as well as the pathological changes has been studied and found to be suggestive of a virus cause for the disease. The absence of perivascular demyelinization removes the case from the realm of acute disseminated encephalomyelitis and establishes it more or less definitely as a primary acute infectious myelitis. An extremely important feature of the pathological picture of this disease has been the presence of focal necrosis in the viscera (spleen, adrenals, regional lymph nodes). Attempts to transmit the disease to Macacus rhesus monkeys, dogs, mice, and guinea pigs, employing glycerinated organs from the human case, proved unsuccessful. By the inoculations of rabbits the presence of a strongly neurotropic, filtrable virus was demonstrated in the patient's brain, cord, and spleen. Following intracutaneous injection of it as derived either from brain and cord or spleen, an experimental disease develops in rabbits which strikingly resembles the human disease in the character of the local lesion, the incubation period, development of urinary retention, and flaccid paralysis of the posterior extremities with cephalad progression, death by respiratory failure, and finally by the occurrence of focal necrosis in the spleen, adrenals, and liver. In attempting to establish the identity of this virus, (the B virus), a consideration of its biological properties excludes the viruses of poliomyelitis, rabies, vaccinia, Virus III disease of rabbits, and the other viruses which are known to produce similar intranuclear inclusion bodies, except perhaps herpes. Although the relationship between the B virus and the virus of herpes must still be determined by cross-immunity tests it has been shown to possess certain properties which warrant consideration of it as a distinct entity.

The fate of three proteins, crystalline hen's egg albumin, crystalline bovine plasma albumin, and human plasma gamma-globulin, was traced after intravenous injection into mice. This was done by preparing frozen sections of quick-frozen tissue, allowing what foreign protein might be present in the section to react with homologous antibody labelled with fluorescein, and examining the section under the fluorescence microscope. By this means, which employs the serological specificity of the protein as a natural "marker," all three of these proteins were found in the cells of the reticulo-endothelial system, the connective tissue, the vascular endothelium, the lymphocytes of spleen and lymph node, and the epithelium of the kidney tubules, the liver, and in very small amounts in the adrenal. The central nervous system was not studied. All three persisted longest in the reticulo-endothelial system and the connective tissue, and in the doses employed egg white (10 mg.) was no longer detectable after 1 day, bovine albumin (10 mg.) after 2 days, and human gamma-globulin (4 mg.) after 6 days, although in a somewhat higher dose (10 mg.) human gamma-globulin persisted longer than 8 days. Egg albumin differed from the others in not being detectable in the cells of the renal glomerulus. It was found that each of the three proteins was present in the nuclei of each cell type enumerated above, often in higher concentration than in the cytoplasm. Further, some of the nuclei not only contained antigen, soon after injection, but were also surrounded by a bright ring associated with the nuclear membrane. By means of photographic records under the fluorescence microscope of sections stained for antigen, and direct observation under the light microscope of the same field subsequently stained with hematoxylin and eosin, it could be determined that the antigen was not adsorbed to chromatin or nucleoli, but was apparently in solution in the nuclear sap.