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THE ORAL ADMINISTRATION OF PROSTIGMIN IN THE TREATMENT OF MYASTHENIA GRAVIS

HENRY R. VIETS, M.D.; ROGER S. MITCHELL, M.D.; ROBERT S. SCHWAB, M.D.
JAMA. 1937;109(24):1956-1959. doi:10.1001/jama.1937.02780500012004.
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Shortly after the introduction in 1934 of parenterally administered prostigmin in the treatment of myasthenia gravis, prostigmin given orally was also shown to be effective in ameliorating the symptoms of this disease. Administering doses of 30 mg. by mouth three times a day, Everts1 had encouraging results in two patients after two or three months of treatment. No untoward symptoms were noted. Only a few other reports have appeared: those of Schneider,2 Laurent and Walker3 and Smith4 and a report from our clinic by Mitchell.5

It was soon found that 30 mg. of prostigmin by mouth was about as effective as 0.5 mg. given subcutaneously or intramuscularly. The ordinary dose by mouth therefore was from three to six tablets, of 15 mg. each, a day. Laurent and Walker,3 beginning about June 1935, soon ran out of supplies of prostigmin to be given orally and

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