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To the Editor:—
Dr. Julius Winston's reply in The Journal, Jan. 21, page 268, and his reference to my work (Ann Otol67:185, 1958), needs some clarification.Undoubtedly there have been cases that have responded to individual steroids; but in our series of cases, my colleagues and I purposely avoided cortisone and any of its derivatives, since these, to be effective, must be given in doses above physiologic levels. We have used the whole adrenal cortex extract, which has about 1 mg. of cortisonelike activity per 10 cc. of aqueous solution. This is about 10% of the normal production of cortisone by a healthy adrenal cortex in 24 hours. Our results have been postulated on the interaction of the approximately 32 hormones included in the adrenal cortex extract and not simply on one individual hormone.In contradistinction to the possibly deleterious and temporary results obtained when cortisone products are
Goldman HB. Labyrinthine Hydrops. JAMA. 1961;176(5):465. doi:10.1001/jama.1961.03040180067020