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August 13, 1955


Author Affiliations

Veterans Administration Hospital 2650 Wisconsin Ave. N. W. Washington 7, D. C.

JAMA. 1955;158(15):1390. doi:10.1001/jama.1955.02960150060021

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To the Editor:—  In his recent article on the treatment of hypertension (J. A. M. A.158:359-367 [June 4] 1955) Dr. Grimson has taken issue with me on two points: (1) the use of neostigmine to overcome constipation produced by the ganglion-blocking agent, and (2) administration of the morning dose of the orally given blocking agent after, not before, breakfast. I have advocated 15 to 30 mg. of neostigmine taken orally on an empty stomach as being generally the most effective method for overcoming the constipating effects of the ganglion-blocking agents, particularly pentolinium. Dr. Grimson, however, has found in anesthetized dogs, rendered hypotensive with pentolinium, that the intravenous injection of neostigmine will result in a rise of blood pressure back to or toward control levels. On the basis of these studies Dr. Grimson concludes that we are producing the same effect in patients. During the past three years we

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