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The New York Times June 3, 1950
Clinical Success Is Reported in Adrenal-Cortical Therapy for Alcoholic and Narcotic
Restoring of Normal Function of Body Described by Doctors
to the Geriatrics Society

A new hormone-injection treatment for alcoholics that can be extended to narcotics addicts was described in detail here yesterday to members of the American Geriatric Society.

Two doctors associated with the Flower and Fifth Avenue Hospitals reported that the administration of extracts from the adrenal glands resulted in "striking and immediate" clinical improvement.

"Endocrine therapy with adrenal cortical extract eliminates the torturing drying out period in alcoholism and lessens significantly the recurrent craving for alcohol," they said. "It makes possible the successful treatment of barbiturate and narcotic addiction in the general hospital without specialized medical attention."

The report was made by Dr. Harold W. Lovell, who, earlier in the day, was elected president of the society, meeting at the Commodore Hotel. Associated with him in his work and report was Dr. John W. Tintera.

Expanding a paper they gave before the society last year, the two doctors came to the conclusion that alcoholism and narcotic addiction were based on inter-related psychological and physical causes.

Adrenal Insufficiency Noted

To treat patients, they suggested a three-point program which included a high fat, medium protein and low carbohydrate diet and referral to Alcoholics Anonymous in addition to their adrenal cortical extract injections.

They also proposed hospitalization for alcoholic patients who were drinking at the time the treatment was started and for all narcotic addicts under treatment.

In their biological analysis of alcoholics and narcotics addicts, Dr. Lovell and Dr. Tintera singled out malfunctioning of the adrenal glands, located on top of the kidneys. They selected the term "hypoadrenocorticism" to identify the disorder and to indicate a level of adrenal insufficiency.

They observed that emotional factors, such as worry, grief and fear, might act as alarming stimuli for adrenal deficiencies and that this hypoadrenocorticism, in turn, was responsible for nervous symptoms, such as irritability, depression and negativism.

A low blood sugar level usually follows and the alcoholic becomes weak, restless, unstable, fearful, sweaty and often develops pallor and dilated pupils, they said. Then comes a craving for alcohol and, in some, for carbohydrates, such as candy.

Two Types of Alcoholics

The doctors found two distinct groups of alcoholic patients, one described as constitutionally hypoadrenocortic and the other acquired, apparently through alcoholic overindulgence.

The first group included tall, thin males with soft smooth faces and little or no chest hair, who usually report a low tolerance for alcohol from the first time they used it. The second group included men who drank successfully for many years, often 15 to 20, before succumbing to alcoholism.

The first group was regarded as highly susceptible to alcohol and the most likely of the various constitutional types to become alcoholic at an early age.

"Continued drinking decreases the blood sugar further, the liver glycogen stores become depleted and fatty infiltration of the liver occurs," the report continued. "The liver in this state is unable to detoxify circulating estrogens, with resultant loss of body hair and signs of feminism appearing in the chronic alcoholic."

The problem of the barbiturate and narcotic addict was described as similar in many respects to that of the alcoholic. The treatment outlined was similar, but more intensive.

Reversal of the Process

The pathological processes were reversed, according to the doctors, by the administration of adrenal cortex extract (ACE). This mobilized glycogen from tissue protein , increased the blood sugar and initiated a return toward normal functioning of the liver.

"It is a great revelation to the defeated alcoholic or drug patient to find he can attain a normal, relaxed level with glandular therapy and an altered dietary regimen," the doctors said.

Their hormonal therapy consists of intravenous injections of 30 cc of aqueous adrenal cortex in three doses of 10 cc each in the first twenty four hours; two doses of 10 cc each the next day, and one dose on each of the following three days.

Following the patient's discharge from the hospital, smaller doses are injected intramuscularly twice a week for four weeks and then at weekly intervals for an indefinite period. The doctors also suggested following the patient for at least a year.

The doctors reported that Adrenocorticotrophic hormone (ACTH) was effective in all types of acute alcoholism, but said they preferred ACE for continuation therapy, because of "complications" associated with the use of ACTH.

"Therapy is relatively simple, nontoxic and entirely safe under the guidance of any competent physician," they concluded.

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