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MYASTHENIA GRAVIS

HENRY R. VIETS, M.D.
JAMA. 1945;127(17):1089-1096. doi:10.1001/jama.1945.02860170001001.
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In the last eight years there has been considerable advance in our knowledge of myasthenia gravis. This somewhat rare disease is characterized by easy fatigability of the voluntary muscles. A growing interest in the disease is based on a number of recent developments: the formulation of the chemical mediation theory of the transmission of nerve impulses across a synapse by the peripheral release of a specific agent, first suggested by Otto Loewi1 in 1921 to explain the actions of the autonomic nerves on their effector organs and later expanded by Dale, Feldberg and Vogt2 to account for a similar reaction at the end plates of motor nerves to voluntary muscles; the discovery in 1934-1935 by Walker3 of the therapeutic effects of physostigmine and prostigmine (neostigmine) in alleviating the symptoms of myasthenia gravis, and the stimulation given by Blalock,4 whose removal of the thymus in 1941 in

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