Pituitary Cachexia with Disturbance of Circulatory Regulation. Result of Treatment with Prolan

Abstract

A case of extreme wasting associated with amenorrhœa for eighteen months. On finding that the subject showed a fall of blood-pressure with unaltered pulse-rate on sitting up, anterior pituitary dysfunction (Simmonds' syndrome (?)) was diagnosed and prolan (Bayer) was administered. Following 100 units intramuscularly administered, the circulatory response became normal in twenty-four hours. The pulse rapidly improved in strength and all circulatory symptoms disappeared within a week. Weight increased at first rapidly, and the nutrition, skin and hair improved remarkably. Metabolism of sugar, as shown by glucose tolerance tests, became normal, and evidence for improvement in fat metabolism is brought forward. The study of the case goes to support the conclusion of Schellong that a function of the anterior pituitary is to influence the circulatory response to muscular effort. That hypotonia of itself is not responsible for the circulatory symptoms is shown by the failure of ephedrine (which raised the blood-pressure) to remove the circulatory symptoms. Contrary to some accepted beliefs, prolan, which is prepared from urine of pregnant mares, has a profound metabolic effect, as well as an effect on the ovary. The diagnostic value of the circulatory response in doubtful cases is discussed.