OKGANOTHERAPY AND HOKMONOTHEBAPY 115 



was controlled after other therapy had failed. 30 While other authors 

 have expressed views similar to those of Renon and Delille, these do not 

 seem to have been accepted by the majority of clinicians. In a con- 

 siderable number of my own cases of circulatory disease, injections of 

 pituitrin have appeared to exert little if any favorable influence on the 

 circulatory function other than an indirect one due to their effect in 

 the relief of abdominal distention (see below), for which they have no 

 superior. 



There are numerous clinical reports that the administration of 

 posterior pituitary substance has produced good effects on the circulation 

 in the sepsis of infectious diseases, peritonitis, and infected wounds. 

 Among others who hold such views is Delille, who used it in a series of 

 twenty-eight cases of typhoid, of which two died, while another had in- 

 testinal hemorrhages. This author states that "in all these cases the 

 institution of pituitary therapy was followed more or less rapidly and 

 to a greater or less degree by a rise in the blood-pressure, slowing of the 

 pulse, increased diuresis, and improvement of the general condition." A 

 shortening of the period of convalescence was also claimed. In spite of 

 such reports, it would seem that posterior pituitary substance, when ad- 

 ministered subcutaneously to typhoid patients, must by its action on peris- 

 talsis increase the danger of hemorrhage and perforation. In personal 

 experience with cases of other infections, in which the typhoid "state had 

 developed, my own failure to observe anything more than an occasional 

 very slight and temporarily beneficial effect on the circulation, leads me 

 to advise against injections of pituitary extract in cases of typhoid fever; 

 and I am unable to believe in its efficiency when administered orally. 

 However, if these injections do not cause either hemoTrhage or perfora- 

 tion, they may well prove useful by prevention or relief of the tympanites 

 which so often aggravates the condition of typhoid cases. 



In other septic conditions there are not the same objections to the 

 administration of posterior pituitary substance, and the view is quite 

 widely held that here it frequently exerts a beneficial action on the 

 circulation. Blair Bell (c) (1919) states that "in sepsis of a serious char- 

 acter such as may occur in appendicitis or puerperal infection, infun- 

 dibulin (a posterior pituitary extract) is of the very greatest value." 

 He injects 0.5 c.cm. of infundibulin intramuscularly twice daily as long as 

 the symptoms are acute. Schmidt has shown that in the clinic, pituitrin 

 raises the diastolic pressure in febrile conditions. Borchardt (&), after 

 reviewing the literature, reaches the conclusion that in infections the ad- 

 ministration of posterior pituitary substance is clearly indicated only in 



30 Every clinician of sufficient experience is aware of the difficulty of determining 

 whether the cessation of one of these paroxysms following any line of treatment is an 

 instance of post hoc or propter hoc. However, there is pharmacological evidence that 

 the injection of extracts of this gland may directly depress cardiac muscle and in 

 this way it is possible that such would exert a favorable influence in tachycardia. 



