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Steroids for Treatment of Shock

G. E. Breen, MD
JAMA. 1965;193(6):545. doi:10.1001/jama.1965.03090060135021.
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To the Editor:—  Having been using the steroids, not only for shock but for the acute infections, for the past 13 years, I am bewildered by the extraordinary discrepancy between the opinions of various clinicians on this subject, and I feel that we are allowing our patients to suffer, and sometimes die, because of failure to recognize their remarkable capacity to reverse the febrile inflammatory reaction. No doubt much of this is due to a failure to understand the principles governing their use—a situation which I have done my best to remedy in this country.In your editorial "Waterhouse-Friderichsen Syndrome" (JAMA192:569 [May 10] 1965) you say "Replacement of steroids in shock is sometimes life-saving when given in massive doses. Levin and Cluff suggest that the treatment of the Waterhouse-Friderichsen Syndrome in this manner is worth a trial." May I point out that successful treatment of this condition with


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