Methacholine Test and Epinephrine and Arterenol Excretion

Abstract

Funkenstein, Greenblatt, and Solomon^1,2have published a prognostic test for the selection of neuropsychiatric patients for electric shock treatment. In essence, the test consists of administering 10 mg. of methacholine (Mecholyl) chloride intramuscularly and observing the systolic blood pressure for 25 minutes. In cases in which the systolic pressure was elevated two basic types of response were described: (A) that in which the systolic pressure failed to return to the preinjection level within the 25-minute period, and (B) that which showed a return to the control level during the observation period. Those subjects showing the first type of response were considered, by the authors, to have a significantly more favorable prognosis when subjected to EST than those showing the second type of response. The underlying physiological mechanism explaining these results was attributed to excess epinephrinelike secretion in the (A) type, while the (B) type was said to have an