Marasmus

MARASMUS (from Greek marasmos—prostration, exhaustion), wasting, the fading of the organism. The concept of marasmus is extremely close to cachexia (see), and by many authors these concepts are united (Podvysotsky, Nikiforov, Ziegler, and others). Indeed, if one singles out the so-called "senile marasmus," a quite definite concept, the differentiation of other types of marasmus from cachectic states does not appear possible; hence the term marasmus is gradually being displaced, often being replaced by the term cachexia. Synonyms for marasmus are "marcor" and "macies," which now, however, are encountered in literature extremely rarely and are associated not with the idea of the fading of the entire organism, but with phenomena of exhaustion and the disappearance of the fat depots of the subcutaneous tissue.—S e n i l e marasmus, marasmus senilis, presents sharp phenomena of exhaustion and wasting of the organism, which develop toward the end of the senile involution of the latter. A sign of this marasmus is the combination of far-advanced anatomical and functional senile changes, the prototype of which may be considered the so-called "simple or senile atrophy" (atrofia senilis, s. marasmus senilis; Podvysotsky), extending to almost all organs and systems, wherein in the picture of senile marasmus a very important role is played by the phenomena of atrophy of the skeleton, muscles, and integuments, which determine the characteristic habitus of the marantic organism. The atrophy of organs and systems is accompanied by a sharp weakening of their functional capacity. Besides somatic changes, senile marasmus is characterized by a significant weakening of mental activity, which is caused by atrophic changes in the cerebral cortex (for details on the picture of senile marasmus and the causes of its occurrence, see Oldliness).—Other types of marasmus, arising independently of the senile involution of the organism, are united into the group of so-called premature marasmus (marasmus praematurus). As already noted above, the term marasmus here is overlapped by the term cachexia. In contrast to senile marasmus, premature marasmus encompasses a group of pathological processes that are very diverse not only etiologically and pathogenetically, but to a sufficient degree different in their symptoms as well. All these processes are united basically by the extreme degree of emaciation and exhaustion of patients, a peculiar wrinkled appearance of the skin and its earthy color, i.e., such a habitus of patients that resembles the organism during the period of its senile involution. A fairly frequent phenomenon in marasmus is the tendency to the formation of thrombi, which are usually localized in the veins of the lower extremities, in the pelvic vessels, and in children in the sinuses of the dura mater and are formed as a result of the weakening of blood circulation (marantic thrombi). Due to the same weakening of blood circulation in marasmus, gangrenous phenomena can arise (primarily on the lower extremities), which are obtained especially easily in the presence of even insignificant pressure produced from without (marantic gangrene); sometimes edema is also formed (marantic edema).

E. Tatarinov.