Studies on the relation of the adrenal glands to allergic phenomena: 3. On the specific therapeutic effects of cortical adrenal extract in asthma

Abstract

T HE remarkable therapeutic effects of epinephrine in the asthma.tic attack focus attention on the medullary portion of the adrenal gland. The loss of appetite and asthenia complained of by so many chronic asthmatic persons, the hypochlorhydria and low blood pressure simulate t,he symptoms of adrenal cortical insufficiency and suggest the use of cort,ical extracts in this disease. Early in 1930 me administered a potent cortical extract to a boy twelve years of age, an asthenic chronic asthmatic, whose attacks were due to contact with feathers, house dust,, and orris root. Environmental control of contact with these substances over a period of several mont,hs failed to stop the symptoms and hyposensitization with these substances was considered. Before carrying this out, homever, he was placed on a cortical adrenal extract (Interrenalin) by mouth in dosage adequate to relieve the symptoms of Addison’s tlisease in adult pat,ients, and all other symptomatic treatment was tliscontinued. During a five weeks trial of this substance there were severe asthmatic attacks and no significant change in the general condition. The extract was at, this time discontinued, and hyposensitization was carried out. Since a demonstrably potent extract had failed to affect the asthma in this case, and since the extract was expensive and difficult to prepare, it, was not considered worth while to administer it to any other asthmatic patients. In March, 1933, Finemanl published his observations on the use of a commercial cortical adrenal extract (Eschatin) in four adhmatic patients. He reported that, one shorned marked improvement, one moderate, one slight and one no improvement. He felt that, ‘<The results obtained with suprarenal cortical extract in the four ca,ses studied and reported warratnt its further t,rial in a larger series of cases, employing larger dosage and utilizing, if necessary, the intravenous route. ” Because of t,his report we decided to make further observations. Accordingly we administered Interrenalin for a period of six weeks