Hench, P. S.; Kendall, E. C.; Slocumb, C. H., and Polley, H. F.:  Effects of Cortisone Acetate and Pituitary ACTH on Rheumatoid Arthritis, Rheumatic Fever and Certain Other Conditions: A Study in Clinical Physiology , Arch. Int. Med. 85:545-666 (
(April)
) 1950;.
Thorn, G. W.; Forsham, P. H.; Frawley, T. F.; Hill, S. R., Jr.; Roche, M.; Staehelin, D., and Wilson, D. L.:  Medical Progress: the Clinical Use fulness of ACTH and Cortisone , New England J. Med. 242: 824-833 (
(May)
) 1950;.
Baehr, G., and Soffer, L. J.:  Treatment of Disseminated Lupus Erythematosus with Cortisone and Adrenocorticotropin , Bull. New York Acad. Me[ill] 26: 229-234 (
(April)
) 1950;.
Proceedings of the First Clinical ACTH Conference , edited by J. R. Mote, Philadelphia, The Blakiston Company, 1950;.
Plotz, C. M.; Blunt J. W., Jr., and Ragan, C.:  Effect of Pituitary Adrenocorticotropic Hormone (ACTH) on Disseminated Lupus Erythematosus , Arch. Dermat. & Syph. 61:913-918 (
(June)
) 1950;.
Oppel, T. W.; Coker, C., and Milhorat, A. T.:  The Effect of Pituitary Adrenocorticotropin (ACTH) in Dermatomyositis , Ann Int. Med. 32:318-324 (
(Feb.)
) 1950;.
The low sodium diet of the Presbyterian Hospital contains less than 0.5 Gm. of sodium chloride daily.
At the time this study was initiated, the consensus of investigators indicated that 100 mg. of pituitary adrenocorticotropic hormone was comparable to 200 mg. of cortisone. Subsequent study has shown that 100 mg. of pituitary adrenocorticotropic hormone approximates the effect of 250 to 300 mg. of cortisone. Doses of 250 to 300 mg. of cortisone were not employed in this study on the differential effects of pituitary adrenocorticotropic hormone and cortisone in collagen diseases because initial observations indicated to us a qualitative rather than a quantitative differential effect. The increased incidence of undesirable physiological effects with larger doses of cortisone was felt to be a contraindication to these doses.
Rose, E., and Pillsbury, D. M.:  Lupus Erythematosus (Erythematodes) and Ovarian Function: Observations on a Possible Relationship, with Report of 6 Cases , Ann. Int. Med. 21: 1022-1034 (
(Dec.)
) 1944;.
Contratto, A. W.:  Periarteritis Nodosa: A Report of 2 Cases, One with Special Reference to Sensitivity Factors , Arch. Int. Med. 80:567-578 (
(Nov.)
) 1947;.
Fischel, E. E.:  The Relationship of Adrenal Cortical Activity to Immune Responses , Bull. New York Acad. Med. 26: 255-260 (
(April)
) 1950;.
Armstrong, S. H., Jr., and Hawn, C. V. Z.: Personal communication to the authors.
Waring, G. W., Jr., and Weinstein, L.:  Effect of Gamma Globulin on Circulating Human Complement , Science 105: 479 (
(May 2)
) 1947;.
Schwab, L.; Moll, F. C.; Hall, T.; Brean, H.; Kirk, M.; Hawn, C. V. Z., and Janeway, C. A.:  Experimental Hypersensitivity in the Rabbit , J. Exper. Med. 91:505-526 (
(May)
) 1950;.
Kolmer, J. A., and Boerner, F.: Approved Laboratory Technic , New York, Appleton-Gentury-Crofts Company, Inc., 1945;, p. 677.
Mayer, M. M.; Eaton, B. B., and Heidelberger, M.:  Spectrophotometric Standardization of Complement for Fixation Tests , J. Immunol. 53: 31-35 [
(May)
] 1946;.
Mayer, M. M.; Osler, A. G.; Bier, O. G., and Heidelberger, M.:  The Activating Effect of Magnesium and Other Cations on the Hemolytic Function of Complement , J. Exper. Med. 84:535-548 [
(Dec.)
] 1946;
Wolbach, S. B., and Bessey, O. A.:  Tissue Changes in Vitamin Deficiencies , Physiol. Rev. 22: 233-289 (
(July)
) 1942;.
 Chemical Tests and Their Interpretation; Nutrition Surveys: Their Techniques and Value, Committee on Nutrition Surveys, Food and Nutrition Board, Division of Biology and Agriculture , Bull. Nat. Res. Council 117:47-81 (
(May)
) 1949;.
Shick, R. M.; Baggenstoss, A. H., and Polley, H. F.:  Effects of Cortisone and ACTH on Periarteritis Nodosa and Cranial Arteritis: Preliminary Report , Proc. Staff Meet., Mayo Clin. 25:135 (
(March 15)
) 1950;.
Armstrong, S. H., Jr.; Budka, M. J. E.; Morrison, K. C., and Hasson, M.:  Preparation and Properties of Serum and Plasma Proteins: XII. Refractive Properties of Proteins of Human Plasma and Certain Purified Fractions , J. Am. Chem. Soc. 69: 1747-1753 (
(July)
) 1947;.
Armstrong, S. H., Jr.:  Mechanisms of Action of Serum Albumin Therapy in Internal Medicine , Am. J. Med. 4:390-397 [
(March)
] 1948;.
Thorn, G. W.; Forsham, P. H.; Prunty, F. T. G., and Hills, A. G.:  A Test for Adrenal Cortical Insufficiency: Response to Pituitary Adrenocorticotropic Hormone , J. A. M. A. 137: 1005-1009 (
(July 17)
) 1948;.
It is of interest that the initial eosinophil drop occurred when the pretreatment level was approximately 300 per cubic millimeter, and the failure of drop was encountered when the pretreatment level was below 100 per cubic millimeter.
Randolph, T. G., and Rollins, J. P.:  Eosinophil Observations in Adrenocorticotropic Hormone (ACTH) Therapy , in Mote, J. R.: Proceedings of the First Clinical ACTH Conference , Philadelphia, The Blakiston Company, 1950;, pp. 1-13.
Dr. Louis R. Limarzi, Associate Professor of Medicine, University of Illinois College of Medicine, made careful bone marrow studies on three of our patients who had disseminated lupus. Dr. Limarzi reported moderate to marked bone marrow stimulation following treatment with pituitary adrenocorticotropic hormone, cortisone, or both, and the presence of L. E. cells, clumping of the neutrophils, or both, even after therapy.
These patients are in addition to other patients with the syndrome under observation in this clinic during the past year.
In one patient with incipient but not fully developed potassium insufficiency, cause was found in the presence of undisintegrated potassium chloride tablets in the stools.
Hoefer, P. F. A., and Glaser, G. H.:  Effects of Pituitary Adrenocorticotropic Hormone (ACTH) Therapy: Electroencephalographic and Neuropsychiatric Changes in 15 Patients , J. A. M. A. 143:620-624 (
(June 17)
) 1950;.