The paralysis of autonomic ganglia, with special reference to the therapeutic effects of ganglion-blocking drugs / by W.D.M. Paton.

  • Paton, William D. M.
Date:
[1951?]
Catalogue details

Licence: In copyright

Credit: The paralysis of autonomic ganglia, with special reference to the therapeutic effects of ganglion-blocking drugs / by W.D.M. Paton. Source: Wellcome Collection.

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    Effect on Gastric Activity We owe to Kay and Smith (1950a, 1950b) the studies of the action of hexamethonium on gastric function. These workers have shown decisively that intramuscular doses of hexamethonium will inhibit spontaneous secre¬ tion of hydrochloric acid to the point of achlorhydria, will reduce the volume and acidity of spontaneous night secretion of gastric juice, and will inhibit the motor activity of the intestine and relieve ulcer pain when this is present. They also find that it reduces the gastric secretion to insulin-induced hypoglycaemia, but does not affect the response to histamine. They have con¬ tinued their studies, using larger doses by oral adminis¬ tration, and have found a similar reduction in gastric secretion. Hexamethonium has also been shown radio¬ graphically to reduce the emptying time of the stomach considerably, and to lessen the mobility of the duodenum and jejunum (Douthwaite and Thorne, 1951). It is clear from this work that hexamethonium is potentially important for the treatment of peptic ulcer. A hopeful beginning has already been made (Scott, Kay, O’Hare, and Simpson, 1950) on the diffi¬ cult task of establishing whether it does in fact accelerate healing of peptic ulcer as well as relieve pain. But it is still uncertain, for instance, whether such bene¬ ficial effect is due to depression of acid gastric secretion or to depression of gastric and intestinal motility. “ Side-actions ” Bromism and iodism can be avoided by the use of non-toxic salts of hexamethonium (Paton and Walker, 1951 ; Campbell and Robertson, 1951). The technique of diminishing undesired elements of the syndrome of ganglionic block (arbitrarily termed “ side-actions ” is still developing. Severe ileus should not be allowed to persist: neostigmine is effective (Bourne and Hosford, 1951). Fall in blood pressure may, in view of Enderby’s results, be less hazardous than it appears. Postural control is obviously of prime importance, but control of blood pressure by sustained infusions of adrenaline has nothing to recommend it: “ adrenaline shock,” which may be lethal, has been known for over 30 years (Blackett, Pickering, and Wilson, 1950). Future Work The actions of hexamethonium in man hold thera¬ peutic promise and, as one reviews them, are all attributable solely to ganglionic block. With this promising beginning, one turns to consider future lines