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November 1956

Experience with Corticotropin and Corticosteroids in Severe Peritonitis

Author Affiliations

Oakland, Calif.
From the Department of Surgery and the Institute for Metabolic Research, Highland Alameda County Hospital.

AMA Arch Surg. 1956;73(5):804-812. doi:10.1001/archsurg.1956.01280050072014

It is generally recognized that the patient with an adrenocortical insufficiency has a poor tolerance to infection, even of a minor nature. It is also recognized that an overwhelming sepsis may produce a relative adrenal insufficiency. With the isolation and development of the adrenocorticotropic hormone of the pituitary and the various steroids of the adrenal cortex, an impetus was given to the study of the effects of these hormones on patients with severely toxic states.* Kass, Ingbar, and Finland showed that the course of a severe penumococcus pneumonia could be altered by the use of hormones alone.7 These experiences by others led to the use of corticotropin in the case of a child who was severely toxic from a generalized peritonitis. The changes produced in this child were striking. Within 24 hours, the patient who had been moribund was clinically less toxic, had active peristalsis in contrast to a

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