STUDIES ON THE TRIPLE RESPONSE OF LEWIS IN PATIENTS WITH SPINAL CORD INJURY

[摘要] Flare reactions to stroking and intradermal histamine injection were studied in 68 patients with spinal cord injury (6 quadriplegic and 62 paraplegic). The flare to stroking below the level of injury was absent in 54 of the patients, but more so in the clinically complete paraplegic patients. The corresponding flare loss to intradermal histamine below the level of injury was not as striking. No quadriplegic patient showed a loss. Twenty-four of the 62 paraplegics showed a loss, while another twenty-six showed flare reactions reduced in size and color intensity. A review of the literature on the flare in the axon reflex is presented. The decreased flare reaction found below the level of spinal cord injury by us and others is yet unexplained, but may depend on the decreased ability of the skin to release histamine, impaired integrity of the nerves, lessened ability of the small blood vessels to dilate and loss of central nervous control. The reaction to nicotine intradermally as shown by pilo-erection and sweating were identical above and below the level of injury in paraplegics with levels below T-4. The flare loss to nicotine corresponds to the flare loss with histamine.