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Samuel Karelitz, M.D.
JAMA. 1927;89(19):1602-1603. doi:10.1001/jama.1927.92690190001012a.
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In 1925, Duzar,1 while studying blood pressure in childhood, observed that epinephrine given intravenously to children suffering from chorea caused cessation of choreiform movements for a period of from ten to fifteen seconds. As the effect of the epinephrine wore off the choreiform manifestations returned. By applying this observation empirically, he hoped to be able to cure chorea with repeated injections of epinephrine. Desiring to use large doses of epinephrine, he produced an alkalotic reaction of the blood by giving large doses of sodium bicarbonate.

Appreciating the significance of Sydenham's chorea and its allied rheumatic manifestations, and also that until this time arsenicals, bromides, nonspecific protein therapy and other medications have not proved to be adequate remedies, we welcomed Duzar's suggestion and believed it worthy of trial.

He outlined the following procedure, which he used as a routine:

1. Sodium bicarbonate, from 20 to 30 Gm., is given daily


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