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THE TREATMENT OF INVOLUTION MELANCHOLIA WITH OVARIAN HORMONE
Karl M. Bowman; Lauretta Bender
Am J Psychiatry 1932;88:867-893.
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Harvard Medical School, Chief Medical Officer, Boston Psychopathic Hospital

Boston Psychopathic Hospital

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Abstract

Seven cases of involutional melancholia were treated with ovarian hormone in the form of Squibb's amniotin. The method and amount of treatment varied. A careful study before and after treatment was made of the blood pressure, basal metabolism, blood chemistry, (including non-protein nitrogen, uric acid, cholesterol, fasting sugar and sugar curve), and the galactose tolerance.Two cases showed a good social recovery (Cases 1 and 5). Three cases were unimproved and now show a chronic picture (Cases 2, 3 and 6). Keeping in mind Dreyfus' findings, it is still possible that recovery may occur, but if it should, the amniotin treatment could not be regarded as playing any part in the recovery. Two cases died, Case 4 of anemia and broncho-pneumonia, Case 5 of carcinoma of the uterus. Our treatment, therefore, appears to have had little or no effect on the final outcome of these cases.In giving amniotin, we had in mind the possible restoration of the menstrual cycle. The results were quite different. Except in Case 1, where a very slight flow occurred on two occasions, the effect of treatment was to cause complete cessation of the menses. In Cases 3, 4 and 5, there was menstruation up to the time of treatment, but none after treatment started. In Case 2, menstruation continued for two months after treatment and then ceased. Case 6 had had a pan-hysterectomy so that no changes were possible. Case 7 had had the menopause II years previously and treatment produced no effect.Very little change occurred in the blood chemistry during treatment. Where such changes did occur they were usually in the direction of a more normal condition. However, some cases did show disturbances in weight, arterial tension, an increase in nonprotein nitrogen not due to any apparent cardio-renal-vascular disease, a low blood cholesterol, disturbances in sugar curves, and low basal metabolism. These may all be favorably influenced by glandular therapy, especially the specific female sex hormone. Such therapeutic measures may improve the patient's general physical condition, alleviate distressing symptoms, remove abnormal sensations which may be feeding delusional trends, shorten remissions, and in some instances are apparently associated with complete clinical recoveries.An intelligent application of such therapeutic measures specifically directed against known symptoms and laboratory findings may offer a valuable means of treating properly selected cases. Patients who show depression, indecision, delusional trends directed against the environment, and without visceral disturbances and their associated hypochondriacal trends, will probably not be benefited by such treatment. Re√ęstablishment of menses should not be the aim. On the other hand, it may be possible to hasten a complete cessation of menses where the disturbance includes an annoying continuance of scanty, irregular menses or metrorrhagia of the menopause not due to uterine pathology. The combination of the sex hormone with other forms of organotherapy, especially with thyroid in cases of low metabolism, and with pituitary, obviously suggests itself.

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