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The purpose of this study was to evaluate the effects of orphenadrine citrate (Norftex) in the syndrome of "restless legs" and nocturnal leg cramps. Of the original 32 patients, 12 were dropped from the study because of gastrointestinal Intelerance to the first few doses of the drug or because they were unreliable observers; the symptoms subsided as soon as orphenadrine was discontinued. In the 20 remaining patients the drug was well tolerated; they received it in an oral dosage of 100 mg (occasionally 200 mg) daily for periods ranging from three months to one year. Orphenadrine citrate was found to be an effective therapeutic agent by itself in 16 of the 20 cases, and in combination with other drugs in 4 cases.

It is the purpose of this paper to report on the clinical evaluation of certain dihydrogenated alkaloids of ergot in the management of chronic peripheral vascular diseases. This study covered a 2 year period. The diseases treated were arteriosclerosis obliterans, thromboangiitis obliterans, vasospastic disorders comprising Raynaud's disease and Raynaud's syndrome and obstructive edema of the extremities. The following hydrogenated ergot alkaloids, dihydroergocristine (DCS 90), dihydroergocorinine (DHO 180) and dihydroergokryptine (DHK 135) were used in an equimixture known as CCK 1'79. j' This report augments an earlier publication by this author (1).Crude ergot has been used as a medicine for centuries. It was known early for its oxytocic properties. The fundamental studies were first made by Dale (2) in 1906 who recognized 2 active principles in ergot. The action of the first principle was a direct stimulation of smooth muscle including blood vessels; the action of the second was the inhibition of sympathetic activity. This sympatholytic effect was latent and completely overshadowed by the direct smooth muscle stimulating property. Several alkaloids were later isolated from ergot; namely, ergotamine, ergosine, ergocristine, ergokryptine, ergocornine and ergobasine. Stoll and Hoffman (3) in 1943 produced a new series of compounds by hydrogenating these alkaloids. Rothlin (4) demonstrated that hydrogenation decreased the toxicity of the natural alkaloids and increased the latent sympatholyticadrenolytic property with the result that this property dominated much of the pharmacological activity.Recent investigations have confirmed and added to our knowledge of the sympatholytic-adrenolytic property. Considerable literature (5-34) has accumulated concerning its actions in man and animals. Two sites of activity have been demonstrated, central and peripheral. The central action is complex; the major effects being due to an inhibition of the vasomotor center leading to a lowering of the vascular tone, peripheral vasodilatation and diminution of arterial tension. Other central effects reported are bradycardia, inhibition of the pressosensory reflexes and sedation. Its peripheral actions are chiefly latent adrenosympatholoytic upon functions stimulated by epinephrine and upon functions inhibited by epinephrine. These actions depend primarily upon the dosage and experimental animal used. Recent reports of favorable clinical activity in man at NORTH DAKOTA STATE UNIV LIB on June 26, 2015 ang.sagepub.com Downloaded from