Summary The alimentary symptoms found in 107 consecutive cases of Parkinsonism have been compared with those found in 96 control subjects. Chewing difficulty, drooling of saliva, dysphagia, frequent heartburn and constipation all occurred significantly more often in Parkinsonism than in controls, and of these symptoms only the incidences of dysphagia and heartburn did not correlate with increasing disability from Parkinsonism. There was relatively little correlation between alimentary symptoms and ætiological type of Parkinsonism, though chewing difficulty occurred particularly in Parkinsonism following encephalitis lethargica, and constipation in paralysis agitans. The alimentary symptoms of Parkinsonism may be due to dorsal vagal nuclear and basal ganglia lesions, and to side effects of drug therapy.

The in vitro binding of diphenylhydantoin (DPH) to the lJrotein in plasma from 97 volunteers has been studied using ultrafiltration at 37° C. The capacity of plasma protein to bind DPH did not ditfer significantly between pregnant women (11.6 ± 1.7% of total drug unbound), women taking oral contraceptives (9.9 ± 1.7% unbound), healthy males (10.6 ± 1.3% unbound), and healthy females (11.0 ± 3.2% unbound). However, in plasma trom patients with renal disease (15.8 ± 3.9% unbound), hepatic disease (15.9 ± 6.0%) or hepatorenal disease (15.6 ± 5.4%), the protein binding of DPH was significantly decreased. These changes in protein binding were found to correlate better with changes in albumin and bilirubin levels in plasma than with any of 13 other biochemical parameters examined.

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