Studies on the Autonomic Functional State in Urolithiasis Report I. Pharmacodynamic Tests and Mechanical Tests in Urolithiasis

摘要

In this paper, the author discuss the general f eature of the neurovegetative backgrounnd in urolithiasis. The author examined the autonomic functional state of preoperative and post-operative condition in urolithiasis with pharmacodynamic tests and mechanical tests. I. Pharmacodynamic test Varieties of the re s p onses manifested by the patients were classified into four groups according to the exhibited type of manifestation : Type V, Type VS, Type S and Type 0. Any subject responding to either adrenaline or pilocarpine or to both was labelled as autonomically dystonic. Name of sympathicotonia was given to those subjects who were more sensitive to adrenaline than to pilocarpine, while the name of vagotonia was given to those who were more sensitive to pilocarpine than to adrenaline. 1) Of 158 patients with urinary calculi, there were 6 1 cases (37.9%) with sympathicotonia and there were 130 cases (82.2%) with parasympathicotonia, including 44 cases (27.8%) of Type VS. 2) Of 158 pat i e nts with urinary calculi, there were 147 cases (93.0%) with positive signs of autonomic dystonia, including 86 cases (54.4%) of vagotonia. These autonomic dystonia of urolithiasis continured mo r e over in postoperative condition 3) In multiple or recurrent stone formating patients also the author recognized the autonomic dystonia with more sensitive to pilocarpine. 4) In urolithiasis, the type of respon s e of autonomic functional condition with pharmacodynamic tests was scarcely changed after and before operation. If the type was changed, its change was the transition from the unstable autonomic type to the other, and it scarcely happened that the change was to statable type. II. With mechanical tests (Dermographia, Aschner's phenomenon, Czermak's phenomenon and respiratory arythmia) in urolithiasis also the author recognized the autonomic dystonia. From the these results the author concluded that urinary stone formating patients is many cases in the state of autonomic dystonia especially hypertonia of parasympathetic nervous system with pharmacodynamic tests and mechanical tests. This suggests that neurovegetative factors have important bearing on the pathogenesis of the urinary calcu li.