The more numerous the remedies for a disease the less likely that any will prove consistently helpful. Of the many drugs recommended for hyperpiesia (essential hypertension) there is no agreement on the best to employ, and none has gained any outstanding reputation. There seems to be no authoritative statement on the comparative value of these remedies, and individual drugs have been praised without controlled clinical observations. The urge for trying new remedies in hyperpiesia is prompted by the common incidence of a condition which produces bizarre symptoms and determines many complications. Although for this reason treatment is a matter of great concern, it is not likely to be very successful while the cause remains unknown.This paper deals primarily with the effects of certain drugs on the blood pressure in patients with hyperpiesia, and also records our observations on the influence of changes in the blood pressure on the subjective symptoms. We are not concerned here with the advisability of reducing blood pressure in hyperpiesia, but our findings during short periods of a lowered pressure have convinced us that the presence of symptoms has little or no relation to the level of the blood pressure. The opportunity, however, of observing the results of a greatly lowered blood pressure in hyperpiesia over a long period has only been gained through the onset of cardiac infarction or heart failure, when the appearance of newer symptoms might mask the direct effects of the lowered pressure.
METHOD OF OBSERVATIONWe submitted the following preparations to clinical trial: sodium nitrite, glyceryl trinitrate, erythrol tetranitrate, mannitol hexanitrate, bismuth subnitrate, potassium iodide, iodine, potassium bromide, sodium luminal, chloral hydrate, papaverine sulphate, euphyllin, diuretin, theominal, doryl, pacyl, hypotan, calcium chloride, atropine, potassium thiocyanate, benzyl benzoate, guipsine, detensyl, phyllosan, citrin, yohimbine hydrochloride, padutin, vagotonine, angioxyl, bioglan H, anabolin, perandren, and cestrone. We selected these remedies either on account of a reputation which they already held in the treatment of hyperpiesia or on account of their pharmacological action in producing a fall in blood pressure. Many of the proprietary preparations were 199
