568 the tocopherols 



4. Primary Fibrositis and Related Disorders 



Under this heading are included conditions generally regarded as meta- 

 bolic disorders of the connective tissues and represented by Dupuytren's 

 contracture, Peyronie's disease, and generalized involvement of muscles 

 such as seen in myositis, fibromyositis, muscular rheumatism, lumbago, 

 and bursitis. The reported beneficial effects of tocopherol therapy have been 

 ascribed to effects upon the vascular bed or upon altered connective tissues, 

 perhaps through correction of some localized metabolic disturbances in the 

 involved tissues. 



Steinberg's observations^" that Dupuytren's contracture freciuently re- 

 sponds favorably to high tocopherol dosage have been extended by him^' ^^ 

 and confirmed by certain investigators^^' ^^ but not by others.'^^- '^^ It is 

 noteworthy that in the two most recent studies, where tocopherol was the 

 sole form of treatment and plaster casts were used to measure changes in 

 flexion deformity, definite though moderate improvement was observed 

 in 23 of 26 affected hands in one study '^^ and no improvement noted in 58 

 hands in the other .'^^ 



Peyronie's disease (fibrous infiltration of the intercavernous septum of 

 the penis), which is not uncommonly associated with Dupuytren's con- 

 tracture, ''^''^^ is said to respond favorably to tocopherol therapy ,^^' '^"^^ al- 

 though negative or negligible responses are not infreciuent. Similar results 

 have been reported in the treatment of urethral stricture*" and interstital 

 cystitis.^"^ No contrary findings have as yet been reported. 



There is also the interesting observation of Edgerton ct at. ^^ that tocoph- 

 erol frequently relieves the pain associated with keloids when other meas- 

 ures have failed but does not prevent the development of these areas of 

 dense scar tissue. This is attributed to softening of the scar tissue, perhaps 

 through correction of underlying metabolic or vascular disturbances. This 



'0 C. L. Steinberg, Med. Clin. N. Amer. 30, 221 (1946). 



" C. L. Steinberg, Arch. Surg. 63, 824 (1951). 



" G. R. Thomson, Brit. Med. J. II, 1382 (1949); Glasgow Med. J. 30, 329 (1949). 



'3 J. E. Kirk and M. Chieffi, Proc. Soc. Exptl. Biol. Med. 80, 565 (1952). 



7* R. A. King, /. Bone and Joint Surg. 318, 443 (1949). 



75 H. J. Richards, Brit. Med. J. I, 1328 (1952). 



76 T. Katz-Galatzi, Acta Med. Orient. 8, 193 (1949); cited by W. W. Scott, Yearb. 

 Urol., p. 320 (1950). 



" J. I. Waller and W. C. Dreese, /. Urol. 68, 623 (1952). 



78 W. W. Scott and P. L. Scardino, Southern Med. J. 41, 173 (1948). 



79 P. L. Scardino and W. W. Scott, Ann. N. Y. Acad. Sci. 52, 390 (1949). 



80 P. L. Scardino and P. B. Hudson, Ann. N. Y. Acad. Sci. 52, 425 (1949). 

 80a R. E. Van Duzen and R. Mustain, J. Urol. 65, 1033 (1951). 



81 M. T. Edgerton, Jr., E. M. Hanrahan, and W. B. Davis, Plastic Reconstr. Sury. 8, 

 224 (1951). 



I 



