Abstract A major task in geriatrics is management of manifestations of the degenerative changes peculiar to the aging process. Among these manifestations are two types of intermittent pain in the muscles of the lower extremities: the pain of intermittent claudication, and night cramps. The pathogenesis of intermittent claudication has come to be widely recognized; it is a pain of exercise, caused by inadequacy of blood supply in proportion to blood demand, much as is the anginal effort pain, and like the latter it is an expression of organic or spastic narrowing of vessels carrying blood to the muscles involved. The pain of night cramps, like the pain of claudication, is intermittent, affects preponderantly the middle-aged and elderly and involves the same muscle groups. It is because of these obvious similarities that night cramps too have been generally considered a symptom of peripheral vascular disease. It is a common experience of specialists References 1. Pemberton, R.: Arthritis and Rheumatoid Conditions , Philadelphia, Lea & Febiger, 1935, p. 53. 2. Pemberton, R., and Foster, G. L.: Studies on Arthritis in the Army Based on Four Hundred Cases , Arch. Int. Med. 25:243 ( (March) ) 1920.Crossref 3. Unpublished data. 4. Kennedy, F., and Wolf, A.: Experiments with Quinine and Prostigmin in Treatment of Myotonia Congenita , Arch. Neurol. & Psychiat. 37:68 ( (Jan.) ) 1937. 5. Moss, H. K., and Herrmann, L. G.: Quinine for Relief of Night Cramps in the Extremities , J. A. M. A. 115:1358 ( (Oct. 19) ) 1940. 6. Harvey, A. M.: Action of Quinine on Neuro-Muscular Transmission , Bull. Johns Hopkins Hosp. 66:1 ( (Jan.) ) 1940. 7. Harvey, A. M.: Mechanism of Action of Quinine in Myotonia and Myasthenia , J. A. M. A. 112:1562 ( (April 22) ) 1939. 8. While the explanation given in these paragraphs is an obvious oversimplification of the physiology of neuromuscular impulse transmission, omitting among other factors the vital role of migration of potassium between muscle tissue and serum and the related effects of rest and exercise in myasthenic and myotonic states, it does help to illuminate the parallel relationships involved in night cramps. 9. Brown, D.: The Regulation of Energy Exchange in Contracting Muscles , Biol. Symposia 3:161, 1941. 10. Manson-Bahr, P. H.: Manson's Tropical Diseases , ed. 10, Baltimore, William Wood & Company, 1936, p. 71. 11. Yorke, W., and Murgatroyd, F.: Malaria , Ann. Trop. Med. & Parasitol. 25:551, 1931. 12. Best, C. H., and Taylor, N. B.: Physiologic Basis of Medical Practice , Baltimore, William Wood & Company, 1937, p. 1101. 13. Bennett, A. E., and Cash, P. T.: Curarization with Quinine Methochloride to Prevent Traumatic Complications of Metrazol Shock Therapy , Psychiatric Quart. 15:351 ( (April) ) 1941.
Archives of Internal Medicine – American Medical Association
Published: Apr 1, 1943