ACETYL-BETA-METHYLCHOLINE IN ADDISON'S DISEASE

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Abstract
It has long been established that the disturbances in water, electrolyte and carbohydrate metabolism in acute adrenal cortical insufficiency may be corrected by adequate replacement therapy. Under certain circumstances, however, sudden circulatory collapse and even death may occur in patients with Addison's disease despite control of these other factors. These circumstances notably include infections, minor traumatic injuries or operative procedures, and they sometimes take place without apparent cause. Swingle and his associates1 have pointed out that fatal collapse in adrenalectomized animals need not involve changes in salt and water balance. Loeb2 has observed a number of patients with Addison's disease who died a typical addisonian death but without the characteristic chemical changes in the blood serum and while receiving desoxycorticosterone. He has suggested that a disturbance in vasomotor regulation, either peripheral or central, may be responsible and that this is not consistently controlled by the cortical hormones now