PARKINSONISM is not generally considered to be hereditary. Many textbooks of neurology mention only that cases have been reported in which heredity appeared to play a part. However, the impression that parkinsonism has a hereditary tendency has been documented by a number of authors. Doshay feels that idiopathic parkinsonism has a well-defined hereditary liability, that it is related to myoclonic epilepsy, and that both these conditions represent a form of "cumulative metabolic neuronal lipoidosis." 1 Medea and Clerice in 1898 reported the illness to be present in 4 of 10 siblings.2 In 1899 Collins and Muskins commented on the high incidence of this affliction in the Irish, and 4 of their reported 24 patients had "a straight forward history of direct inheritance." 3 In these 4, one of the parents was afflicted, and in 3 of the 4 cases an aunt or an uncle also had the disease.Hart in 1904 reported 16% of his cases had a family history of parkinsonism.4 Patrick and Levy in 1922 found "neuropathic" heredity in 25% of their cases and direct heredity in 6 cases.5 Having reviewed the literature of familial incidence of paralysis agitans, Kehrer in 1930 recorded its frequent pres¬ ence in siblings and in father-son combinations.8 Allan in 1937 reported 72 consecutive patients with parkinsonism of whom 45 had near relatives with the same disorder.7 Of these, complete family his¬ tories of 24 of the 45 patients were obtained. Six whole sibships having palsy were reported, and in 8 instances there was skipping of a generation.Allan concluded that in two-thirds of the cases which he studied parkinsonism was inherited as a dominant trait. Wilson and Bruce in their textbook on neurology reviewed the literature and found 11 examples of parkinsonism in 2 or more siblings and 21 with occurrences in several generations.8 They noted that Erb had estimated heredity in this disease to be 15%. Mjones obtained positive family histories in 41% of his "idiopathic" cases of parkin¬ sonism, in 42% of the encephalitic cases, and in 19% of the "arteriosclerotic cases." 9 He compiled pedigrees of families in which the affliction was present in members of several generations. He no¬ ticed that the trait behaved as a dominant charac¬ teristic with incomplete penetrance. Kurland, in a detailed investigation of neurologic and myopathie disorders in Rochester, Minn., found a history of the illness in immediate members of the family in "at least 16%" of the idiopathic cases.1" The follow¬ ing is the report of a family in which the incidence of parkinsonism is so high that it is suggestive of a dominant characteristic.A 36-year-old woman had been asymptomatic and healthy until November, 1959, when she noted a twitching of her left eyelid which continued for a month. She experienced generalized stiffness, weakness, and a tremor of the left side of her body. She was unable to use her left arm well and suffered a loss of associated motion. Her ability to perform fine movements was impaired, and emotional lability with a tendency to cry easily develope...

The bronchodilator effect of fenoterol hydrobromide (0.5, 1.25, and 2.5 mg) was compared with either isoproterenol (2.8 mg) or isoetharine (5 mg) with phenylephrine (1.25 mg) in a double-blind placebo-controlled study. When delivered by an intermittent positive-pressure breathing device to 24 nonsmoking young adult asthmatic subjects, fenoterol produced significant improvement in forced expiratory volume at 1 second (FEV1), in maximum midexpiratory flow (FEF25-75%), and in forced expiratory flow at 25 per cent of vital capacity (FEF25%) for 6 to 8 hours, whereas isoproterenol and isoetharine with phenylephrine produced improvement for 1 and 2 hours, respectively. The lowest dosage of fenoterol was as effective as the highest but had fewer adverse effects.

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