ADRENERGIC BLOCKADE AND THYROTOXICOSIS

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Abstract
Guanethidine was used to induce adrenergic blockade in a patient with exophthalmic goiter. When a postural fall of blood pressure was attained with a large dose of guanethidine, the abnormal tremor was abolished, the sleeping pulse rate fell and the basal metabolic rate fell to + 20% of normal. The addition of methyl thiouracil caused a return of the sleeping pulse rate, basal metabolic rate, body weight and plasma cholesterol to normal levels. Guanethidine alone or in combination with methyl thiouracil did not affect the exophthalmos. Reasons are advanced for suggesting that thyroid hormone acts independently of the increased peripheral sensitivity to the catecholamines in producing many of the signs of thyrotoxicosis. A simple method of recording the tremor in thyrotoxicosis is described.

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