[Lyautey and medicine]. / Lyautey et la médecine.

Medicine played a main role during Lyautey own life. He had recourse to it at many times when he was a young boy and suffering of a lot of bad illness all along his life, chiefly in Africa. Maybe it's the reason which allows the strong interest of Lyautey for medicine and doctors? Then medicine is also, according to Lyautey's mind, the most means for conquest and pacification. He proceeded on that way, especially in Marocco which became, owing to him, a modern and peaceful kingdom.

Algodystrophy. A spectrum of disease, historical perspectives, criteria of diagnosis, and principles of treatment.

Algodystrophy describes a group of extremely polymorphic pathological manifestations caused by vasomotor disturbances. Clinical expressions of algodystrophy are summarized, and principles of treatment are discussed.

[History perspective of parasitic rheumatisms]. / Historique des rhumatismes parasitaires.

For many centuries, it was believed that "rheumatisms" had an intestinal origin. The very important frequency of rheumatic diseases, and the equally very important frequency of parasitic diseases, explain that the random association of both conditions is very frequent; and numerous authors, in the past, concluded (without sufficient proof), to the parasitic origin of some rheumatic diseases. Later many authors denied any relation between parasitic and rheumatic diseases, after a critical study of papers published about the so-called "parasitic rheumatism".

[Henry Foley and the discovery in 1908 of the role played by the louse in the transmission of relapsing fever]. / Henry Foley et la découverte du rôle du pou dans la transmission de la fièvre récurrente et du typhus exanthématique.

The author recalls the very fine clinical, epidemiological and experimental work undertaken since 1907 at Beni Ounif de Figuig, south of Oran near the algerian-moroccan border which led Henry Foley and Edmond Sergent to suspect and later demonstrate the exclusive role played by the louse (Pediculus corporis or more precisely P. vestimenti) in the transmission of relapsing fever of which they studied an important epidemic occurring there between 1907-1910. This discovery led them to incriminate also the louse in the transmission of exanthematic typhus of which the epidemiology is practically similar. On the occasion of a tunisian epidemic of relapsing fever Charles Nicolle resumed Sergent's and Foley's work which he contested without any justification. Trying to attribute to himself all the merit of the discovery of the role of the louse in the transmission of relapsing fever, Charles Nicolle quotes Sergent's and Foley's works contesting them with a certain bad faith. In 1912 he mentions only Sergent's and Foley's 1910 works (posterior of only one year to his confirmation of the role of the louse in the transmission of exanthematic typhus) and ignores totally their 1908 preliminary paper. One must therefore give full credit to Henry Foley associated with Edmond Sergent for this essential discovery of the role of the louse in human pathology in which they occupy the first place.

[Spinal diseases in a rheumatology hospital unit in Lomé (Togo)]. / Pathologie rachidienne en consultation rhumatologique à Lomé (Togo).

A retrospective study was conducted to determine the different kinds of spinal diseases in patients attending the rheumatology unit of Lomé hospital, Togo. Among the 4927 patients seen over a 5-year period, 1966 (40%) had spinal involvement. The disease observed were as follows: degenerative spinal disorders: 1872 cases (95%); infectious discitis: 41 cas (2.1%); spondyloarthropathies: 33 cases (1.8%); tumors: 20 cases (1.1%). Degenerative spinal involvement affected mainly lumbar and cervical spine. The only unusual clinical feature was that Schober's index was often normal. Lumbar spinal stenosis was common (233 cases, 12.4%), especially in females, and occurred at an earlier age than in the Western world. Ankylosing spondylitis features included mildness of extra-articular manifestations and an often negative family history. Pott's disease was de leading cause of infectious discitis. The present study suggests that spinal disorders are as frequent in Africa as in Western countries.

[Coxofemoral pathology in rheumatology consultation in Togo]. / Pathologie coxo-femorale en consultation rhumatologique au Togo.

A retrospective study was conducted to determine the relative incidence and characteristics of the different forms of coxofemoral disease encountered in a hospital rheumatology clinic in Lomé (Togo). Hemoglobin electrophoresis was performed in all subjects included in the study. Of 2812 subjects examined over a 44-month period, 80, i.e. 2.8%, presented clinically and radiologically documented coxofemoral disease. Necrosis of the femoral head was the cause of coxofemoral disease in 36 subjects i.e. 45%, and was the most frequent etiology. In these 36 subjects hemoglobin was normal in 5 cases, type AS in 5, type AC in 1, type SS in 9, and type SC in 16. Coxarthrosis was detected in 31 subjects: either primary (n = 20) or secondary (n = 11). In this group, hemoglobin was normal in all but 3 subjects who exhibited type AS. The other etiologies observed were coxitis (n = 20) and epiphysitis (n = 3). This study documents the major role of hemoglobinopathy in the pathogenesis of coxofemoral disease in Black Africa. It confirms that AS and SC heterozygoses are not involved in the onset of aseptic necrosis.

[Henry Foley and Lyautey, and the medical activities in Morocco during the initial phase of the protectorate]. / Henry Foley et Lyautey, et l'action médicale au Maroc à la phase initiale du Protectorat.

In June 1912, Lyautey was called to Marocco as "Résident général". His first decision, before his arrival in Marocco, at Fès, was to require an important additional quota of physicians. He received each of them, in order to verify their moral and professional capacity to assume their charge. Lyautey knew that he must contribute to the modernization and development of this very old, fascinating and glorious nation, which was no longer suited to the modern time. Among the necessary and urgent actions, the medical one seemed to be the more important. Lyautey had found with Henry Foley, all the essential qualities to manage the medical assistance service for marocan populations. But Foley refused to be with Lyautey in Marocco, because he was working in the saharian city of Beni-Ounif, on different subjects as exanthematous typhus, recurrent fever ... He had discovered in 1908, the role of lice in the transmission of recurrent fever in Beni-Ounif, one year before the discovery of this role in exanthematic typhus by Charles Nicolle. But the relation proved by not yet published correspondence, was not broken off between Foley and Lyautey.

[Degenerative spinal disease in an outpatient clinic in Lomé (Togo)]. / Pathologie dégénérative du rachis en consultation hospitalière à Lomé (Togo).

A survey was conducted to determine the frequency and semiological characteristics of degenerative spinal disease in patients attending a hospital rheumatology outpatient clinic in Lomé, Togo. Seven hundred and one of the 1,821 patients seen over a two-year period had degenerative spinal disease. Spinal disease included lower back pain (n = 385), lumbar and radicular pain suggestive of disk protrusion (n = 137), lumbar and radicular pain with claudication suggestive of stenosis of the spinal canal (n = 42), dorsal pain (n = 24), cervical pain (n = 68) and cervical and brachial pain (n = 45). Clinical patterns were similar to those seen in Western countries. However, lumbar and radicular pain with claudication suggestive of stenosis of the spinal canal occurred at a younger age and mainly affected females. These data are in contrast with previous studies suggesting that lumbar and radicular pain due to disk protrusion and stenosis of the spinal canal are uncommon in Black Africa.

[Treatment of algodystrophy by regional sympathetic blocks with guanethidine (410 blocks in 98 patients). Preliminary results]. / Traitement de l'algodystrophie par les blocs régionaux sympathiques à la guanéthidine (410 blocs chez 98 patients). Résultats préliminaires.

In a preliminary retrospective study, 418 regional sympathetic blocks with guanethidine administered as treatment of 103 cases of algodystrophy gave 70 p. cent of positive results versus 55 p. cent in case of psychic disorders. The tolerance was correct in 85 p. cent but was decreased by old age.