doi: 10.1001/archinte.1974.00320170013001pmid: N/A
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doi: 10.1001/archinte.1974.00320170033002pmid: N/A
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract So radically has the medical view of hypertension changed in the past 30 years that the recent series of national task force programs sponsored by the National Heart and Lung Institute gave but little mention of the dietary treatment program for hypertension that the Archives has chosen to review in some detail in this issue. The sharp contrast between the impact of the rice diet treatment for hypertension that occurred in the late 1940s and the almost forgotten status of that regimen in the 1970s merits comment. It is clear that the drug treatment of hypertension and the specific surgical treatment of modifiable or removable causes of hypertension have provided less cumbersome and less discommodious types of therapy. When the rice diet treatment was enunciated, it demonstrated that malignant hypertension was a reversible illness, and it surely gave new heart to investigators and clinicians to pursue diligently other avenues of
doi: 10.1001/archinte.1974.00320170034003pmid: N/A
Abstract Considering Walter Kempner's family background, it is not surprising that he chose medical research as a career. By the time of his birth, Jan 25, 1903, both of his parents were active medical investigators. His father made the first antitoxin against the poison of Bacillus botulinus. His mother established the pathogenicity in humans of the bovine strain of Mycobacterium tuberculosis. Both had begun as assistants to Robert Koch, discoverer of the tubercle bacillus. Koch was the godfather of Dr. Kempner's brother who made a name for himself as the American deputy chief counsel in the war crime trials in Nuremberg. Walter Kempner graduated from the Medical School of the University of Heidelberg in Germany in 1926. After internship in Heidelberg, where his first paper, on diabetes, was published, he worked in 1927 to 1928 and again in 1933 to 1934 at the Kaiser Wilhelm Institute for Cellular Physiology in Berlin-Dahlem, References 1. Kempner W: The nature of phlorhizindiabetes. Arch Exp Pathol Pharmacol , 122:1-23, 1927.Crossref 2. Kempner W: Respiration in the plasma of chickens with plague. Klin Wochenschr 6:2386-2387, 1927.Crossref 3. Kempner W, Peschel E: Metabolism of inflammation. Z Klin Med 114:439-455, 1930. 4. Kempner W: Effect of cyanide and carbon monoxide on butyric acid fermentation. Biochem Z 257:41-56, 1933. 5. Kempner W, Kubowitz F: Effect of light on the inhibition of butyric acid fermentation by carbon monoxide. Biochem Z 265:245-252, 1933. 6. Kempner W: Metabolism of human erythroblasts. J Clin Invest 15:679-683, 1936.Crossref 7. Kempner W: Chemical nature of the oxygen transferring ferment of respiration in plants. Plant Physiol 11:605-612, 1936.Crossref 8. Kempner W: Effect of low oxygen tension upon respiration and fermentation of isolated cells. Proc Soc Exp Biol Med 35:148-151, 1936.Crossref 9. Kempner W: Effect of oxygen tension on cellular metabolism. J Cell Comp Physiol 10:339-361, 1937.Crossref 10. Kempner W: Anoxemia of the kidney as a cause of uremic acidosis. Am J Physiol 123:117-118, 1938. 11. Kempner W: Anoxemia of the kidney as a cause of reversible uremic acidosis. Klin Wochenschr 28:971-973, 1938.Crossref 12. Kempner W: Inhibitory effect of low oxygen tension on the deamination of amino acids in the kidney. J Biol Chem 124:229-235, 1938. 13. Kempner W: Effect of the variations of atmospheric oxygen concentration upon the metabolism of tubercle bacteria. Am J Physiol 126:553-554, 1939. 14. Kempner W, Gaffron M: Metabolism of human myeloblasts and its sensitivity toward variations of oxygen tension. Am J Physiol 126:553, 1939. 15. Kempner W: The nature of leukemic blood cells as determined by their metabolism. J Clin Invest 18:291-300, 1939.Crossref 16. Kempner W: Oxygen tension and the tubercle bacillus. Am Rev Tuberc 40:157-168, 1939. 17. Kempner W: The role of oxygen tension in biological oxidations. Cold Spring Harbor Symposia 7:269-289, 1939.Crossref 18. Kempner W, Wise B, Schlayer B: Manometric determinations of the effects of various sulfanilamide compounds on Brucellamelitensis. Am J Med Sci 200:484-492, 1940.Crossref 19. Hanes FM, Kempner W: The effect of various sulfonamide drugs on Pneumococcus, as determined by measuring manometrically the bacterial metabolism. Trans Assoc Am Phys 56:152-164, 1941. 20. Kempner W, Schlayer C, Summers P: Effect of various sulfonamides on hemolytic staphylococcus measured with the manometric technique. Am J Med Sci 203:172-177, 1942.Crossref 21. Kempner W, Schlayer C: Effect of CO2 on the growth rate of the Pneumococcus. J Bact 43:387-396, 1942. 22. Kempner W: Sulfonamide action on Pneumococcus and staphylococcus at various oxygen concentrations and in the absence of oxygen, determined by measuring manometrically the bacterial metabolism. Fed Proc 1:46, 1942. 23. Schlayer C, Kempner W, Summers P: Inhibition of the sulfonamide effect on Pneumococcus by pamino-benzoic acid in the absence of oxygen. Fed Proc 1:78-79, 1942. 24. Kempner W: Treatment of kidney disease and hypertensive vascular disease with rice diet. I. NC Med J 5:125-133, 1944. 25. Kempner W: Treatment of kidney disease and hypertensive vascular disease with rice diet. II. NC Med J 5:273-274, 1944. 26. Kempner W: Compensation of renal metabolic dysfunction. Treatment of kidney disease and hypertensive vascular disease with rice diet. III. NC Med J 6:61-87, 117-161, 1945. 27. Kempner W: Some effects of the rice diet treatment of kidney disease and hypertension. Bull NY Acad Med 22:358-370, 1946. 28. Kempner W: Treatment of cardiac failure with rice diet. NC Med J 8:128-131, 1947. 29. Kempner W: Treatment of hypertensive vascular disease with rice diet. Am J Med 4:545-577, 1948.Crossref 30. Kempner W, et al: Sulfate and phosphate excretion in urine of patients on rice diet. Am J Med Sci 216:687-688, 1948.Crossref 31. Kempner W, Peschel E, Starke H: Rice diet in malignant hypertension: A case history. Am Practitioner 3:556-563, 1949. 32. Kempner W: Treatment of heart and kidney disease and of hypertensive and arteriosclerotic vascular disease with the rice diet. Ann Intern Med 31:821-856, 1949.Crossref 33. Kempner W: Treatment of heart and kidney disease and of hypertensive and arteriosclerotic vascular disease with the rice diet , in Premier Congres Mondial de Cardiologie . II: Paris, France, 1950, vol 2, pp 32-34. 34. Kempner W: The treatment of retinopathy in kidney disease and hypertensive and arteriosclerotic vascular disease with the rice diet. Ophthalmologic Ibero Americana 13:1-40, 1951. 35. Kempner W: Treatment of heart and kidney disease, retinopathy, and arteriosclerotic and hypertensive vascular disease with the rice diet. Arch Med Cuba 3:131-142, 1952. 36. Kempner W: Radical dietary treatment of hypertensive and arteriosclerotic vascular disease, heart and kidney disease, and vascular retinopathy. GP 9:70-93, 1954. 37. Kempner W: Effect of the rice diet in experimental hypertension and in patients with heart, kidney and vascular disease. Z Klin Med 152:328-345, 1954. 38. Kempner W, Peschel E, Black-Shaffer B: Effect of diet on experimental hypertension and the development of polyartertitis nodosa. Circ Res 3:73-78, 1955.Crossref 39. Newborg B, Kempner W: Analysis of 177 cases of hypertensive vascular disease with papilledema: One hundred twenty-six patients treated with rice diet. Am J Med 19:34-47, 1955.Crossref 40. Kempner W, Peschel RL, Schlayer C: Effect of rice diet on diabetes mellitus associated with vascular disease. Postgrad Med 24:359-371, 1958. 41. Kempner W: Effect of salt restriction on experimental nephrosis. JAMA 191:51, 1965.Crossref 42. AMA Council on Drugs: Statement regarding the university group diabetes program study. Diabetes 19, (suppl 2) , VI-VII, 1970. 43. Bierman EL, et al: Principles of nutrition and dietary recommendations for patients with diabetes mellitus. Diabetes 20:633-634, 1971. 44. Veterans Administration Cooperative Study Group on Antihypertensive Agents: Effects of treatment on morbidity in hypertension: Results in patients with diastolic blood pressures averaging 115 through 129 mm Hg. JAMA 202:116-122, 1967.Crossref 45. Veterans Administration Cooperative Study Group on Antihypertensive Agents: Effects of treatment on morbidity in hypertension: II. Results in patients with diastolic blood pressures averaging 90 through 114 mm Hg. JAMA 213:1143-1152, 1970.Crossref
doi: 10.1001/archinte.1974.00320170038004pmid: N/A
Abstract In January 1947, I came to Duke Medical School as professor of medicine, chairman of the Department of Medicine, and physician-in-chief of Duke Hospital. I was directly responsible for the care of staff patients and for any private patients who came to me for medical services. The medical students, interns, and residents supervised the care of the staff patients under guidance from the senior staff and me. They also helped with the care of private patients, both those of my own and of other members of the staff. From the beginning, the students and house staff pointed out to me that edematous patients and patients with malignant hypertension treated by Kempner with his rice diet did better than the patients treated by me with digitalis, diuretics, and moderate sodium restriction. My own observations supported theirs and, with the aid of the Durham-Orange County Heart Association, Bernard C. Holland, MD and
doi: 10.1001/archinte.1974.00320170040005pmid: N/A
Abstract The treatment of hypertensive vascular disease with the rice diet1-5was suggested by observations made on the protein, fat and carbohydrate metabolism of isolated kidney cells under various pathologic conditions (cell injury and/or changes in pH, sodium bicarbonate concentration, oxygen tension and metabolizable substrate6-11). Until 1944 the consensus was that dietary treatment was useful in kidney disease but of no value in hypertensive vascular disease. "The diet in uncomplicated hypertension requires no essential change from the normal. There is no justification for restriction of protein intake, indeed, such restriction may result in anemia and other evidences of malnutrition. Likewise, in the absence of edema or paroxysmal dyspnea, the restriction of salt is unwarranted; claims that such restriction may lower the blood pressure have not been substantiated. Obesity should be avoided for the same reasons that apply to normal individuals and not because of any demonstrated relationship to hypertensive References 1. Kempner, W. Treatment of kidney disease and hypertensive vascular disease with rice diet. North Carolina M. J. , 5: 125-133, 1944. 2. Kempner, W. Treatment of kidney disease and hypertensive vascular disease with rice diet. II. North Carolina M. J. , 5: 273-274, 1944. 3. Kempner, W. Treatment of kidney disease and hypertensive vascular disease with rice diet. J. A. M. A. , 125: 48, 1944. 4. Kempner, W. Treatment of kidney disease and hypertensive vascular disease with rice diet. J. A. M. A. , 125: 60, 1944. 5. Kempner, W. Treatment of kidney disease and hypertensive vascular disease with rice diet, III. North Carolina M. J. , 6: 61-87; 117-161, 1945. 6. Kempner, W. Anoxemia of the kidney as a cause of uremic acidosis: inhibitory effect of low oxygen tension on the deamination of amino acids in kidney tissue. Am. J. Physiol. , 123: 117-118, 1938. 7. Lohmann, R. Biologie der Entzuendung. Ztschr. f. klin. Med. , 135: 316-346, 1938. 8. Kempner, W. Inhibitory effect of low oxygen tension on the deamination of amino acids in the kidney. J. Biol. Chem. , 124: 229-235, 1938. 9. Kempner, W. Verminderter Sauerstoffdruck in der Niere als Ursache der reversiblen uraemischen Acidose. Klin. Wchnschr. , 12: 971-973, 1938.Crossref 10. Kempner, W. The role of oxygen tension in biological oxidations. Cold Spring Harbor Symposia on Quantitative Biology . 7: 269-289, 1939.Crossref 11. Kempner, W. Some effects of the rice diet treatment of kidney disease and hvpertension. Bull. New York Acad. Med. , 22: 350-370, 1946. 12. Goldrtng, W. and Chasis, H. Hypertension and Hypertensive Disease . P. 169. New York, 1944. Commonwealth Fund. 13. Fishberg, A. M. Hypertension and Nephritis . 4th ed. Philadelphia, 1939. Lea & Febiger. 14. Folin, O. Laws governing the chemical composition of urine. Am. J. Physiol. , 13: 66, 1905. 15. Benedict, F. G. A Study of Prolonged Fasting . Washington, 1915. Carnegie Institution of Washington. 16. Starke, H. Unpublished data. 17. Allen, F. M. and Sherill, J. W. The treatment of arterial hypertension. J. Metab. Research , 2: 429, 1922. 18. Volhard, F. Die Behandlung der Nephrosklerosen, Handbuch der Inneren Medizin . Edited by von Bergmann and Staehelin. 2nd ed., pp. 1753-1782. Berlin, 1931. Julius Springer. 19. Page, I. H. and Corcoran, A. C. Arterial Hypertension . P. 79. Chicago, 1945. Year Book Publishers. 20. Kempner, W., Lesesne, J., Newborg, B. and Whicker, C., The sulfate and phosphate excretion in the urine of patients on the rice diet. Am. J. M. Sc. , (in press). 21. Grollman, A. and Harrison, T R. Effect of rigid sodium restriction on blood pressure and survival of hypertensive rats. Proc. Soc. Exper. Biol. & Med. , 60: 52, 1945. 22. Selye, H. and Svone, H. Effect of the diet upon the renotropic, nephrosclerotic, cardiotropic and adrenotropic actions of crude anterior pituitary preparations. Federation Proc. , 5: 93, 1946. 23. Dock, W. The predilection of atherosclerosis for the coronary arteries. J. A. M. A. , 131: 875, 1946. 24. Dock, W. Coronary disease. J. A. M. A. 134: 1197, 1947. 25. Dick, G. F. and Schwartz, W. B. Response of experimental hypertension to rice and fruit juice diet. Proc Soc. Exper. Biol. & Med. , 65: 22, 1947. 26. Kempner, W. Treatment of cardiac failure with the rice diet. North Carolina M. J. , 8: 128-131, 1947. 27. Rabinowitch, I. M. Experiences with a high carbohydrate-low caloric diet for the treatment of diabetes mellitus. Canad. M. A. J. , 23: 489-498, 1930. 28. Kempner, W. and Peschel, E. Stoffwechsel der Entzuendung. Zkchr.f. Min. Med. , 114: 439-455, 1930. 29. Kaplan, L. G. and Katz, L. N. The characteristic electrocardiograms in left ventricular strain with and without axis deviation. Am. J. M. Sc. , 201: 676-693, 1941.Crossref 30. Rykert, H. E. and Hepburn, J. Electrocardiographic abnormalities characteristic of certain cases of arterial hypertension. Am. Heart J. , 10: 942, 1935.Crossref 31. Cecil, R. L. A Textbook of Medicine . 7th ed., p. 1156. Philadelphia, 1947. W. B. Saunders Co.
Dranov, Jonathan;Skyler, Jay S.;Gunnells, J. Caulie
doi: 10.1001/archinte.1974.00320170073006pmid: N/A
Abstract The story of human hypertension research really begins in 1836 as a by-product of Richard Bright's1 investigations into the association of albuminuria and dropsy, which developed the broad concept of systemic vascular disease. In 1872, Gull and Sutton2 formulated the concept that a vascular disease, which they called "arterio-capillary fibrosis," was present as the "primary and essential condition in the morbid state called chronic Bright's disease with contracted kidneys." A new era in the study of hypertension began in 1879 with Frederick Horatio Akbar Mahomed's3,4 report on the first systematic investigation of blood pressure during life. He observed that elevation in blood pressure may either precede or follow renal disease, and he proposed the concept that "what is the cause in one case may be the result in another." That hypertension may occur independent of renal disease and may pursue a variable course was reported by three References 1. Bright R: Tabular views of the morbid appearance in 100 cases connected with albuminous urine, with observations selected with a view of illustrating the symptoms and cure of diseases by reference to morbid anatomy. Guys Hosp Rep 1:380-400, 1836. 2. Gull WW, Sutton HG: On the pathology of the morbid state commonly called chronic Bright's disease with contracted kidney ("arteriocapillary fibrosis"). Med Chir Trans 55:273-326, 1872. 3. Mahomed FA: Some of the clinical aspects of chronic Bright's disease. Guys Hosp Rep 24:363-418, 1879. 4. Mahomed FA: Chronic Bright's disease without albuminuria. Guys Hosp Rep 25:295-416, 1881. 5. von Basch SSK: Über Latente Arteriosclerose und deren Beziehung zu Fettleibigkeit, Herzerkränkungen und anderen Begleiterscheinungen . Vienna, Urban & Schwartzenberg, 1893. 6. Huchard H: Maladies du coeur et des vaisseaux . Paris, Doin, 1889. 7. Allbutt TC: Senile plethora or high arterial pressure in elderly persons. Trans Hunter Soc 77:38-57, 1895. 8. Allbutt TC: Diseases of the Arteries, Including Angina Pectoris . London, Macmillan, 1915. 9. Frank E: Bestehen Beziehungen zwischen chromaffinem Hypertonie des Menschen? Ein Kritischer Beitrag zu der Lehre von der physiopathologischen Bedeutung des Adrenalins. Dtsch Arch Klin Med 103:397-412, 1911. 10. Volhard F, Fahr T: Die brightsche Nierenkrankheit . Berlin, Springer, 1914. 11. Fahr T: Über Nephrosklerose. Virchows Arch [Pathol Anat] 226:119-178, 1919.Crossref 12. Keith NM, Wagener HP, Kernohan JW: The syndrome of malignant hypertension. Arch Intern Med 41:141-188, 1928.Crossref 13. Keith NM, Wagener HP, Barker NW: Some different types of essential hypertension: Their course and prognosis. Am J Med Sci 197:332-343, 1939.Crossref 14. Perera GA: Hypertensive vascular disease: Description and natural history. J Chron Dis 1:33-42, 1955.Crossref 15. Goldring W, Chasis H: Hypertension and Hypertensive Disease . New York, The Commonwealth Fund, 1944. 16. Kincaid-Smith P, McMichael J, Murphy EA: The clinical course and pathology of hypertension with papilledema (malignant hypertension). Q J Med 27:117-153, 1958. 17. Bechgaard P: The natural history of benign hypertension , in Bock KD, Cottier PT (eds): Essential Hypertension: An International Symposium . Berlin, Springer-Verlag, 1960, pp 198-210. 18. Perera GA: The accelerated form of hypertension: A unique entity? Trans Assoc Am Physicians 71:62-68, 1958. 19. Schottstaedt WF, Sokolow M: The natural history and course of malignant hypertension with papilledemia. Am Heart J 45:331-362, 1953.Crossref 20. Platt R, Davson J: A clinical and pathological study of renal disease: Part II. Diseases other than nephritis. Q J Med 19:33-55, 1950. 21. Heptinstall RH: Malignant hypertension: A study of 51 cases. J Pathol 65:423-439, 1953.Crossref 22. Heptinstall RH: Pathology of the Kidney . Boston, Little Brown & Co, 1966, pp 131-154. 23. Harrison TS, et al: Malignant hypertension in pheochromocytoma: Correlation with plasma renin activity. Johns Hopkins Med J 130:329-332, 1972. 24. Hermann H, Mornex R: Human Tumors Secreting Catecholamines . New York, MacMillan Co, 1964. 25. Kaplan NM: Primary aldosteronism with malignant hypertension. N Engl J Med 269:1282-1286, 1963.Crossref 26. Brown JJ, et al: Plasma renin in a case of Conn's syndrome with fibrinoid lesions: Use of spironolactone in treatment. Br Med J 2:1636-1637, 1964.Crossref 27. Del Greco F, et al: Association of accelerated (malignant) hypertension in a patient with primary aldosteronism. J Clin Endocrinol Metab 26:808-814, 1966.Crossref 28. Papper S, Vaamonde CA: Nephrosclerosis , in Strauss MB, Welt LG (eds): Diseases of the Kidney . Boston, Little Brown & Co, 1971, pp 735-768. 29. Heptinstall RH: Renal biopsies in hypertension. Br Heart J 16:133-141, 1954.Crossref 30. McCormack LJ, et al: Effects of antihypertensive treatment in the evolution of renal lesions in malignant nephrosclerosis. Am J Pathol 34:1011-1022, 1958. 31. Laragh JH, et al: Aldosterone secretion in primary and malignant hypertension. J Clin Invest 39:1091-1106, 1960.Crossref 32. Laragh JH, et al: Patterns of adrenal secretion and urinary excretion of aldosterone and plasma renin activity in normal and hypertensive subjects. Circ Res 18 & 19 ( (suppl l) ):158-174, 1966. 33. Kaplan NM, Silah JG: The angiotensin infusion test: A new approach to the differential diagnosis of renovascular hypertension. N Engl J Med 271:536-541, 1964. 34. Kaplan NM, Silah JG: The effect of angiotensin II on the blood pressure in humans with hypertensive disease. J Clin Invest 43:659-669, 1964. 35. Hollenberg NK, et al: Renin secretion in essential and accelerated hypertension. Am J Med 47:855-859, 1969. 36. Laragh JH, et al: Renin, angiotensin and aldosterone system in pathogenesis and management of hypertensive vascular disease. Am J Med 52:633-652, 1972. 37. Masson GMC, et al: Experimental vascular disease elicited by aldosterone and renin. Endocrinology 71:505-512, 1962. 38. Carpenter CCJ, et al: Relation of renin, angiotensin II, and experimental renal hypertension to aldosterone secretion. J Clin Invest 40:2026-2042,1961. 39. Brain MC, et al: Microangiopathic hemolytic anemia: The possible role of vascular lesions in pathogenesis. Br J Haematol 8:358-375, 1962. 40. Capelli JP, et al: Malignant hypertension and red cell fragmentation syndrome. Ann Intern Med 64:128-136, 1966. 41. Scheer RL, Jones DB: Malignant nephrosclerosis in women post partum: A note on microangiopathic hemolytic anemia. JAMA 201:600-604, 1967. 42. Linton AL, et al: Microangiopathic hemolytic anemia and the pathogenesis of malignant hypertension. Lancet 1:1277-1282, 1969. 43. Brain MC, et al: Treatment of patients with microangiopathic hemolytic anemia with heparin. Br J Haematol 15:603-621, 1968. 44. Brain MC, Beck EA: Relationship of intravascular coagulation and intravascular hemolysis. Read before the 57th annual meeting of the American Society for Clinical Investigation, Atlantic City, NJ, 1965. 45. Pickering G: Reversibility of malignant hypertension. Lancet 1:413-418, 1971. 46. Veterans Administration Cooperative Study Group on Antihypertensive Agents: II. Results in patients with diastolic blood pressure averaging 90 through 114 mm Hg. JAMA 213:1143-1152, 1970. 47. Hood B, et al: Analysis of mortality and survival in actively treated hypertensive disease , in Gross F (ed): Antihypertensive Therapy, Principles and Practice: An International Symposium . New York, Springer-Verlag, 1966, pp 370-393. 48. Allen FM: Arterial hypertension. JAMA 74:652-655, 1920. 49. Kempner W: Treatment of hypertensive vascular disease with rice diet. Am J Med 4:545-577, 1948. 50. Dole V, et al: Dietary treatment of hypertension: Clinical and metabolic studies of patients on the rice-fruit diet. J Clin Invest 29:1189-1206, 1950. 51. Grollman A, et al: Sodium restriction in the diet for hypertension. JAMA 129:533-537, 1945. 52. Corcoran AC, et al: Controlled observations on the effect of low sodium dietotherapy in essential hypertension. Circulation 3:1-16, 1951.Crossref 53. Watkin DM, et al: Effects of diet in essential hypertension: I. Baseline study; Effects in 86 cases of prolonged hospitalization on regular hospital diet: II. Results with unmodified Kempner rice diet in 50 hospitalized patients. Am J Med 9:428-440; 441-493,1950.Crossref 54. Newborg B, Kempner W: Analysis of 177 cases of hypertensive vascular disease with papilledema: 126 patients treated with rice diet. Am J Med 19:33-47, 1955.Crossref 55. Page LB, Sidd JJ: Medical management of primary hypertension. N Engl J Med 287:960-967; 1018-1023; 1074-1081, 1972.Crossref 56. Megibow RS, et al: Treatment of hypertension by accelerated sodium depletion. J Mt Sinai Hosp 15:233-239, 1948. 57. Gubner R: Observations on mode of thiocyanate action: Augmentation by mercurial diuresis of the hypotensive effect of thiocyanate. Bull NY Acad Med 26:262, 1950. 58. Tapia FA, et al: Enhanced effectiveness of ganglionic agents in hypertensive patients during administration of a saluretic agent (chlorothiazide): Preliminary communication. Lancet 2:831-833, 1957.Crossref 59. Finnerty FA, et al: Evaluation of chlorothiazide alone in treatment of moderately severe and severe hypertension. Circulation 20:1037-1042, 1959.Crossref 60. Dustan HP: Diets and diuretics in treatment of hypertensive cardiovascular disease. JAMA 172:2052-2056, 1960.Crossref 61. Conway J, Lavwers P: Hemodynamic and hypotensive effects of long term therapy with chlorothiazide. Circulation 21:21-27, 1960.Crossref 62. Winder BM, et al: Antihypertensive action of diruetics: Comparative study of an aldosterone antagonist and a thiazide, alone and together. JAMA 204:775-779, 1968.Crossref 63. Bryant JM, et al: The antihypertensive effects of chlorthalidone: A comparative analysis with benzothiazide compounds. Circulation 25:522-532, 1962.Crossref 64. Barisco C, Hanenson I: A comparison of the antihypertensive and diuretic effects of furosemide and chlorothiazide in hospitalized patients, abstracted. Clin Res 14:446, 1966. 65. Wertheimer L, et al: Furosemide in essential hypertension: A statistical analysis of three double-blind studies. Arch Intern Med 127:934-938, 1971.Crossref 66. Freis ED, et al: Chlorothiazide in hypertensive and normotensive patients. Ann NY Acad Sci 71:450-455, 1958.Crossref 67. Freis ED: Clinical pharmacology and use of chlorothiazide in the treatment of hypertension , in Moyer J (ed): Hypertension (The First Hahnemann Symposium on Hypertensive Disease) . Philadelphia, WB Saunders Co, 1959, pp 545-549. 68. Aleksandrow D, et al: Studies on the mechanism of hypotensive action of chlorothiazide. N Engl J Med 260:51-55, 1959.Crossref 69. Conway J, Palmero H: The vascular effect of the thiazide diuretics. Arch Intern Med 111:203-207, 1963.Crossref 70. Winder BM: The antihypertensive actions of benzothiadiazines. Circulation 23:211-218, 1961.Crossref 71. Brest AN: The therapeutic use of the thiazide derivatives in the treatment of hypertension , in Moyer JH, Fuchs M (eds): Edema: Mechanisms and Management (Hahnemann Symposium on Salt and Water Retention) . Philadelphia, WB Saunders Co, 1969, pp 398-601. 72. Hook JB, et al: Effects of several saluretic-diuretic agents on renal hemodynamics. J Pharmacol Exp Ther 154:667-673, 1966. 73. Gregory LF, et al: The short-term effect of furosemide on electrolyte and water excretion in patients with severe renal disease. Arch Intern Med 125:69-74, 1970.Crossref 74. Nickerson M: Antihypertensive agents and the drug therapy of hypertension , in Goodman LS, Gilman A (eds): The Pharmacologic Basis of Therapeutics , ed 4. New York, Macmillan Co, 1970, pp 728-744. 75. Stunkard A, et al: Studies on hydralazine: Evidence for a peripheral site of action. J Clin Invest 33:1047-1053, 1954.Crossref 76. Brest AN, et al: Mechanisms of antihypertensive drug therapy. JAMA 211:480-484, 1970.Crossref 77. Nickerson M: Drugs inhibiting adrenergic nerves and structures innervated by them: III. Adrenergic neuron blocking agents , in Goodman LS, Gilman A (eds): The Pharmacologic Basis of Therapeutics , ed 4. New York, Macmillan Co, 1970, pp 570-584. 78. Carlson A: Pharmacology of the sympathetic nervous system , in Gross F (ed): Antihypertensive Therapy . New York, Springer-Verlag, 1966, pp 5-14. 79. Gaffney TE, et al: The pharmacology of methyldopa , in Gifford RW (ed): Methyldopa in the Management of Hypertension . West Point, Pa, Merck-Sharp-Dohme, 1972, pp 13-26. 80. Heise A, Kronberg G: Alpha sympathetic receptor stimulation in the brain and hypotensive activity of alpha methyldopa. Eur J Pharmacol 17:314-317, 1972.Crossref 81. Ingenito AJ, et al: A centrally mediated peripheral hypotensive effect of alpha-methyldopa. J Pharmacol Exp Ther 175:593-599, 1970. 82. Henning M, Van Zwieten PA: Central hypotensive effect of alpha-methyldopa. J Pharm Pharmacol 20:409-417, 1968.Crossref 83. Mohammed S, et al: Effect of methyldopa on plasma renin activity in man. Circ Res 25:543-548, 1969.Crossref 84. Weidmann P, et al: Plasma renin activity and blood pressure in terminal renal failure. N Engl J Med 285:757-762, 1971.Crossref 85. Woods JW, Blythe WB: Management of malignant hypertension complicated by renal insufficiency. N Engl J Med 277:57-61, 1967.Crossref 86. Kirkendall WM: The use of intravenously administered methyldopa in hypertensive crises , in Gifford RW (ed): Methyldopa in the Managment of Hypertension . West Point, Pa, Merck-Sharp-Dohme, 1972, pp 67-80. 87. Moser M: Guanethidine and bethanidine in the management of hypertension. Am Heart J 77:423-426, 1969.Crossref 88. Sandler G, et al: Guanethidine resistant hypertension. Circulation 38:542-551, 1968.Crossref 89. Smirk FH, McQueen EG: Use of mecamylamine in the management of hypertension. Br Med J 1:422-425, 1957.Crossref 90. Voile RL, Koelle GB: Ganglionic stimulating and blocking agents , in Goodman LS, Gilman A (eds): The Pharmacologic Basis of Therapeutics , ed 4. New York, Macmillan Co, 1970, pp 585-600. 91. Finnerty FA, et al: Influence of extracellular fluid volume on response to antihypertensive drugs. Circ Res 26 & 27 ( (suppl 1) ):71-82, 1970. 92. Finnerty FA, et al: Clinical evaluation of diazoxide, a new treatment for acute hypertension. Circulation 28:203-208, 1963. 93. Pohl JEF, Thurston H: Use of diazoxide in hypertension with renal failure. Br Med J 4:142-145, 1971. 94. Rubin AA, et al: Acute circulatory effects of diazoxide and sodium nitrite. J Pharmacol Exp Ther 140:46-51, 1963. 95. Mroczek WJ, et al: The importance of the rapid administration of diazoxide in accelerated hypertension. N Engl J Med 285:603-606, 1971. 96. Sellers EM, Koch-Weser J: Protein binding and vascular activity of diazoxide. N Engl J Med 281:1141-1145, 1969. 97. Pitt B, Ross RS: Beta-adrenergic blockade in cardiovascular therapy. Mod Concepts Cardiovasc Dis 38:47-54, 1969. 98. Dolliery CT, et al: Clinical pharmacology of beta-receptor-blocking drugs. Clin Pharmacol Ther 10:765-799, 1969. 99. Prichard NC: Propranolol as an antihypertensive agent. Am Heart J 79:128-133, 1970. 100. Prichard NC, Gillam PMS: Treatment of hypertension with propranolol. Br Med J 1:7-16, 1969.Crossref 101. Buhler FR, et al: Propranolol inhibition of renin secretion: A specific approach to diagnosis and treatment of renin-dependent hypertensive diseases. N Engl J Med 287:1209-1214, 1972.Crossref 102. Frohlich ED, et al: The paradox of beta-adrenergic blockade in hypertension. Circulation 37:417-423, 1968.Crossref 103. Waal HJ: Hypotensive action of propanolol. Clin Pharmacol Ther 7:588-598, 1966. 104. Richardson DW, et al: Effect of propanolol on elevated arterial blood pressure. Circulation 37:534-542, 1967.Crossref 105. Richards FA: Propanolol in hypertension. Am J Cardiol 18:384-386, 1966.Crossref 106. Humphreys GS, Delvin DG: Ineffectiveness of propranolol in hypertensive Jamaicans. Br Med J 2:601-603, 1968.Crossref 107. Hoobler SW, Sagastwine E: Clonidine hydrochloride in the treatment of hypertension. Am J Cardiol 28:67-73, 1971.Crossref 108. Pettinger WA, Mitchell HC: Minoxidil—An alternative to nephrectomy for refractory hypertension. N Engl J Med 289:167-171, 1973.Crossref 109. McAllister RG, et al: Malignant hypertension: Effect of therapy on renin and aldosterone. Circ Res 28-29( (suppl II) ):160-172, 1971. 110. Gifford RW, Richards NG: Hypertensive encephalopathy: Part I. Etiology, pathology and clinical findings. Curr Concepts Cerebrovasc Dis 5:43-46, 1970. 111. Page IH, et al: Cardiovascular actions of sodium nitroprusside in animals and hypertensive patients. Circulation 11:188-198, 1955.Crossref 112. Kincaid-Smith P, et al: Dipyridamole and anticoagulants in renal disease due to glomerular and vascular lesions: A new approach to therapy. Med J Aust 1:145-151, 1970. 113. Baer L, et al: Pseudo-primary aldosteronism: An entity distinct from true primary aldosteronism. Circ Res 26-27( (suppl I) ):203-220, 1970. 114. Biglieri EG, et al: The intercurrent hypertension of primary aldosteronism. Circ Res 26-27( (suppl I) ):195-202, 1970. 115. Spark RF, Melby JC: Hypertension and low plasma renin activity: presumptive evidence for mineralocorticoid excess. 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doi: 10.1001/archinte.1974.00320170084007pmid: N/A
Abstract Pseudotumor cerebri has been described in association with a variety of conditions. One of the more common associations has been with obesity. Despite the usual benignity of this condition, many patients with this disorder have been subjected to various surgical procedures. Surgery was not without complications. This report of nine patients treated with a rice/reduction diet demonstrates that the condition can be reversed by salt restriction and weight reduction with diet alone. Complete reversal of the papilledema and improvement in accompanying metabolic and vascular abnormalities is shown. References 1. Greer M: Benign intracranial hypertension. Neurology 15:382-388, 1965.Crossref 2. Kempner W: Treatment of kidney disease and hypertensive vascular disease with rice diet, I. NC Med J 5:125-133,1944. 3. Kempner W, Newborg B: Analysis of 177 cases of hypertensive vascular disease with papilledema. Am J Med 19:33-47, 1955.Crossref
Simon, Arthur B.;Alonzo, Angelo A.;Feinleib, Manning
doi: 10.1001/archinte.1974.00320170100008pmid: N/A
Abstract Of 382 patients with acute symptoms of coronary heart disease, 160 were hospitalized with acute myocardial infarction, 68 were hospitalized with acute coronary insufficiency, sixteen were hospitalized with acute congestive heart failure, and 138 died before admission to the hospital. Self-treatment with prescribed medications or household remedies was noted in 74% of the entire group, changes in physical activity in 88%, and attention to social proprieties and continuing social obligations in one third. Some forms of activity and self-treatment were potentially harmful. The spectrum of activities was similar for those hospitalized as compared to those who died before hospital arrival. References 1. Feinleib M, Davidson MJ: Coronary heart disease: A community perspective. JAMA 222:1129-1134, 1972.Crossref 2. Kuller L, Lillienfeld A, Fisher R: Epidemiological study of sudden and unexpected deaths in adults. Medicine 46:341-361, 1967.Crossref 3. Kuller L: Sudden death in arteriosclerotic heart disease: The case for preventive medicine. Am J Cardiol 24:617-624, 1969.Crossref 4. Simon AB, Feinleib M, Thompson HK: Components of delay in the pre-hospital phase of acute myocardial infarction. Am J Cardiol 30:476-482, 1972.Crossref 5. Hackett J, Cassem NH: Factors contributing to delay in responding to the signs and symptoms of acute myocardial infarction. Am J Cardiol 24:651-658, 1969.Crossref 6. Moss A, Goldstein S: The prehospital phase of acute myocardial infarction. Circulation 41:737-742, 1970.Crossref 7. Bainton CF, Peterson DR: Deaths from coronary heart disease in persons 50 years of age and younger: Community-wide study. N Engl J Med 268:569-575, 1963.Crossref 8. Simon AB, Alonzo AA: Sudden death in nonhospitalized cardiac patients. Arch Intern Med 132:163-170, 1973.Crossref 9. Lown B, Wolfe M: Approaches to sudden death from coronary heart disease. Circulation 44:130-142, 1971.Crossref 10. Pantridge JF: Mobile coronary care. Chest 58:229-234, 1970.Crossref 11. Nagel EL, et al: Telemetry medical command in coronary and other mobile emergency care systems. JAMA 214:332-338, 1970.Crossref 12. Friedson E: Client control and medical practice. Am J Sociol 65:374-382, 1960.Crossref 13. Thomas CB, Bateman JL, Lindberg EF: Observations on the individual effects of smoking on the blood pressure, heart rate, stroke volume and cardiac output of healthy young adults. Ann Intern Med 44:874-892, 1956.Crossref 14. Regan TJ, Hellems HK, Bing RF: Effect of cigarette smoking on coronary circulation and cardiac work in patients with arteriosclerotic coronary disease. Ann N Acad Sci 90:186-189, 1960.Crossref 15. Regan TJ, et al: Ventricular function in noncardiacs with alcoholic fatty liver: Role of ethanol in production of cardiomyopathies. J Clin Invest 48:397-407, 1969.Crossref 16. Gould L, et al: Cardiac effects of a cocktail. JAMA 218:1799-1822, 1971.Crossref 17. Epstein SE, et al: Angina pectoris: Pathology, evaluation and treatment. Ann Intern Med 75:263-296, 1971.Crossref 18. Atkins JM, et al: Arrhythmias induced by isometric (handgrip) exercise and dynamic exercise, abstracted. Clin Res 19:303, 1971. 19. Schartum S: Ventricular arrest caused by the Valsalva maneuver in a patient with Stokes-Adams attacks accompanying defecation. Acta Med Scand 184:65-68, 1968.Crossref 20. Gabel OV: The mechanism of cardiovascular action of nitroglycerin. Am J Med 29:910-923, 1960.Crossref 21. Frick MH, et al: Hemodynamic effects of nitroglycerin. Circulation 37:160-168, 1968.Crossref 22. Sodeman WA: Diagnosis and treatment of digitalis toxicity. N Engl J Med 273:35-37, 1965.Crossref
Figueredo, Roland;Patel, Thakorbhai G.;Grosberg, Saul;Langsam, Abraham
doi: 10.1001/archinte.1974.00320170108009pmid: N/A
Abstract A patient in hepatic coma due to fulminant hepatitis displayed decerbrate rigidity in addition to a number of neurological deficits including wrist and foot drop. Manifestations of motor neuron palsy have not been hitherto described in fulminant viral hepatitis. Patient Summary A 23-year-old man was admitted with jaundice, dark urine, nausea, and vomiting of four days' duration. His girlfriend had had hepatitis one month earlier. On admission, the patient was alert, conscious, and well oriented, with no abnormal neurological findings.He had marked icterus, and his liver, which was palpable 4 cm below the right costal margin, was firm and tender. Total liver size measured 14 cm in the anterior axillary line. The levels for serum bilirubin, serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) were markedly elevated; the values are shown in the Figure. The results of an Australia antigen test, performed twice, were negative.Forty-eight References 1. Frerichs FT: A Clinical Treatise on Disease of the Liver . London, New Sydenham Society, vol 1, 1861. 2. Greene CH, Farrell E: Liver and biliary tract review for 1940. Arch Intern Med 67:847-869, 1940.Crossref 3. Lichtman SS: Diseases of the Liver, Gall Bladder and Bile Ducts . Philadelphia, Lea & Febizer, 1949. 4. Stokes JF, Owen JR, Holmes EG: Neurological complication of infective hepatitis. Br Med J 2:642-644, 1945.Crossref 5. Adams RD, Foley JM: The neurological disorder associated with liver disease. Proc Assoc Res Nerv Ment Dis 32:198-237, 1952. 6. Denny-Brown D: The cerebral control of movement , in Liverpool University Sherrington Lectures , No. 8.1. Liverpool, Liverpool University Press, 1966. 7. Magendie M: Note sur les fonctions des corps striés et des tuburcules tuburclues quadrijumeaux. J Physiol Exp 3:376-381, 1823. 8. Sherrington CS: Integerative action of the Nervous System . New Haven, Yale University Press, 1906. 9. Denny-Brown D: Disease of the basal ganglia: Their relation to the disorders of movement. Lancet 2:1099-1110, 1960.Crossref 10. Read AE, et al: The neuropsychiatric syndromes with chronic liver disease and an extensive portal-systemic colateral circulation. J Med 141:135-150, 1967. 11. Leigh AD, Card WI: Hepato-lenticular degeneration: Case associated with postero-lateral column degeneration. J Neuropathol Exp Neurol 8:338-346, 1949.Crossref 12. Zieve L, Mendelson DF, Goepfert M: Stunt encephalomyelopathy: I. Recurrent protein encephalopathy with response to arginine. Ann Intern Med 53:33-52, 1960.Crossref 13. Witts LJ: BMA annual clinical meeting: Newport, Monmouthshire, April 12-15. Br Med J 1:1198-1201, 1962.Crossref 14. Pant SS, et al: Myelopathy in hepatic cirrhosis. Br Med J 1:1064-1065, 1963.Crossref 15. Scobie BA, Summerskill WHJ: Permanent paraplegia with cirrhosis. Arch Intern Med 113:805-810, 1964.Crossref 16. Zillig G: Neurologische und Psychologische Befunde bei Leberkrankungen. Arch Psychiat Nervenkr 181:21-52, 1948.Crossref
Chertow, Bruce S.;Plymate, Stephen R.;Becker, Frank O.
doi: 10.1001/archinte.1974.00320170114010pmid: N/A
Abstract A patient with idiopathic hypoparathyroidism was resistant to the usual doses of ergocalciferol. She developed acute renal failure as a consequence of ureteral ligation with secondary renal parenchymal inflammation, and hypercalcemia was noted during the diuretic phase of renal failure. On complete recovery from that renal failure, she became sensitive to doses of ergocalciferol that had previously been ineffective. The occurrence of hypercalcemia in this patient with hypoparathyroidism suggests that the hypercalcemia of acute renal failure may not necessarily be dependent on parathyroid hormone, and in some cases may be related to alterations in vitamin D metabolism or end-organ responsiveness. References 1. Tavill AS, et al: Idiopathic paroxysmal myoglobinuria with acute renal failure and hypercalcemia. New Engl J Med 271:283-287, 1964.Crossref 2. Gossmann HH, Lange H: Hypercalcemia in acute renal failure. Ann Intern Med 69:1332, 1968.Crossref 3. Turkington RW, Delcher HK, Neelon FA: Hypercalcemia following acute renal failure. J Clin Endocrinol Metab 28:1224-1226, 1968.Crossref 4. Segal AJ, Miller M, Moses AM: Hypercalcemia during the diuretic phase of acute renal failure. Ann Intern Med 68:1066-1068, 1968.Crossref 5. Schwartz GH, et al: Hypercalcemia after renal transplantation. Am J Med 49:42-51, 1970.Crossref 6. Maher JF, Freeman RB, Schreiner GI: Hemodialysis for chronic renal failure: II. Biochemical and clinical aspects. Ann Intern Med 62:535-550, 1965.Crossref 7. DeLuca HF, Avioli LV: Treatment of renal osteodystrophy with 25-hydroxycholecalciferol. Arch Intern Med 126:896-899, 1970.Crossref 8. Kimberg DV, Baerg RC, Gershon E: The nature of vitamin D resistance in experimental uremia. Arch Intern Med 126:891-895, 1970.Crossref 9. Kovithavongs T, Becker FO, Ing TS: Parathyroid hyperfunction in acute renal failure. Nephron 4:254-258, 1973. 10. Garabedian M, et al: Control of 25-hydroxycholecalciferol metabolism by parathyroid glands. Proc Natl Acad Sci USA 69:1673-1676, 1972.Crossref 11. Rasmussen H: The relationship between parathyroid hormone and vitamin D. Read before the International Symposium on Clinical Aspects of Metabolic Bone Disease, Detroit, 1972. 12. Galante L, et al: Effect of parathyroid extract on vitamin D metabolism. Lancet 1:985-988, 1972.Crossref 13. Boyle IT, et al: The response of intestinal calcium transport to 25-hydroxy and 1,25-dihydroxy vitamin D in nephrectomized rats. Endocrinology 90:605-608, 1972.Crossref 14. Gray R, Boyle J, DeLuca HF: Vitamin D metabolism: The role of kidney tissue. Science 172:1232-1234, 1971.Crossref 15. Brickman AS, Coburn JW, Norman AW: Use of 1,25-dihydroxycholecalciferol in uremic man. New Engl J Med 287:891-895, 1972.Crossref 16. Hartenbower DL, et al: Possible role of impaired renal production of 1,25 DiOH-cholecalciferol in causing reduced calcium absorption in chronic uremia, abstracted. Clin Res 20:595, 1972. 17. Ireland AW, et al: The calciferol requirements of patients with surgical hypoparathyroidism. Ann Intern Med 69:81-89, 1968.Crossref 18. Pak CYC, et al: Treatment of vitamin D-resistant hypoparathyroidism with 25-hydroxycholecalciferol. Arch Intern Med 126:239-247, 1970.Crossref 19. Klotz HP, Konopka P: Le traitement de l'hypoparathyroidisme idiopathique et post-operatoire par le 25 hydroxycholecalciferol. Ann Endocrinol 33:156-164, 1972. 20. Leeson PM, Fourman P: Increased sensitivity to vitamin D after vitamin D poisoning. Lancet 1:1182-1185, 1966.Crossref
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