THE USE OF ACTH IN THE MANAGEMENT OF GENERALIZED PERITONITIS: A PRELIMINARY REPORT*

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Abstract
SINCE the original demonstration of the effectiveness of cortisone and of ACTH in the suppression of the manifestations of rheumatoid arthritis, it has been found that these agents will also exert a most desirable clinical effect in such diverse disease conditions as bronchial asthma, lupus erythematosus, typhoid fever, ulcerative colitis, and pneumococcus pneumonia. It seems probable that the common denominator which explains the effectiveness of these hormones in such diverse diseases lies in the concept of the interposition of a block between a wide variety of toxins and a multitude of body cells. With this concept in mind, it was decided to evaluate the effect of the administration of ACTH1 and cortisone in patients with severe diffuse peritonitis. Patient SPA: The first patient to be so treated was a boy of 2½ years (Fig. 1), who entered this hospital with a 5-day history of intermittent fever and cough and an 18-hour history of vomiting and abdominal pain. On admission, the patient was extremely toxic and had a rigid abdomen with complete absence of peristalsis. Despite the administration of aureomycin and streptomycin over the first twentjr-four hours, a major degree of toxicity was still present. During the second hospital day, ACTH was administered in a dose of 25 mg. intramuscularly every six hours. By the end of the first twenty-four hours of ACTH therapy, the child was nearly free of fever, was completely free of complaints, and not only had active peristalsis, but had a spontaneous normal stool.

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