The control of harassing disturbances of the nervous system in older people is essential, otherwise despair and deterioration will be the penalty. Two striking examples are paralysis agitans and multiple sclerosis, both recognized for their puzzling onset and defiance of treatment. Empiricism has loomed periodically to give false encouragement—to taunt the patient, eager for help. Meanwhile, clinical investigation has been active in the search for basic etiology and specific therapy.
Among the newer drugs proposed for the treatment of paralysis agitans is tolbutamide, initially used in diabetes mellitus. Its value was suggested during the care of a diabetic patient whose tremors of the hands subsided, permitting him to drink from a cup without spilling the contents.1 Other patients showed equal improvement. The findings are challenged in this issue of The Journal, p. 106, and a rebuttal appears concurrently, p. 166, in support of the original position. Apart from the opposing