To the Editor:—
In discussing the patient with idiopathic edema or periodic swelling, George W. Thorn, MD (206:333, 1968), stated that drugs, including nicotine, inhibit the secretion of the antidiuretic hormone. At least in some patients, just the converse is true with respect to nicotine. For example, if a patient is given a water load and then immediately smokes several cigarettes vigorously, particularly if he is a nonsmoker, there is a prompt fall in urine output, in spite of his relative overhydration. This is presumably due to stimulation of the posterior pituitary gland by the nicotine, with eventual elaboration of the antidiuretic hormone. While studying certain central effects in headache, we had the opportunity to demonstrate this observation repeatedly (Arch Neurol5:590, 1961). I believe that this response to nicotine was employed formerly as an old clinical test for diabetes insipidus.Some patients with idiopathic swelling are long-term