ALTHOUGH the diagnosis of pancreatic-cell adenoma is no longer a medical curiosity, the entity is still rare, only about 400 cases having been reported to date.1 Moreover, the syndrome is important because it offers some clue to a more complete understanding of carbohydrate metabolism. The observation that the administration of corticotropin (ACTH) or of cortisone can correct the hypoglycemia of pancreatic hyperinsulinism2 has raised the problem of the physiological mechanism of action of the hormones. The studies on our patient are germane to this problem. REPORT OF A CASE W. J. H. was a 58-year-old American Legion representative, who was admitted to the Salt Lake Veterans Administration Hospital on Jan. 8, 1951, for evaluation of attacks of bizarre behavior. In 1944 the patient first noticed incoordination of his hands when engaged in prolonged work. This was attributed to nervousness. During the next two years he had endured frequent