PROGRESSIVE scleroderma has long been recognized as a disorder of a general character. Apart from the skin and its appendages, the underlying musculature, the fascia, the tendons, the mucous membrane of the mouth and the bones and joints are also characteristically involved. The sclerotic changes are not restricted only to organs bordering on the skin, but, as evidenced by the autopsy records so far published, may be encountered in internal organs too. Thus Ehrmann1 gave an enumeration of the internal organs concerned (esophagus, lungs, heart, kidneys, liver and incretory glands) and described their involvement in a way that leaves no doubt as to the specifically sclerodermal nature of the symptoms. Since that time, important evidence concerning the subject has been contributed by others too. Thus Podkaminskiy2 described peculiar changes in bone and Weissenbach3 functional disturbances of the esophagus associated with progressive scleroderma.
Characteristic pulmonary changes had already