PORT, WITH REVIEW OF NEUROLOGIC FEATURES

T H E term orthostatic, or postural, hypotension has been applied to a condi-tion characterized by a marked fall in the systolic and diastolic blood pressures when the patient changes from the recumbent to an erect posture. The salient features, besides the orthostatic hypotension, in order of frequency, are: 1. Weakness; 2. Anhidrosis, or hypohidrosis; 3. Increased distress in summer; 4. Greater urinary frequency at night; 5. Variation in pulse rate with change in posture; 6. Loss of libido and potentia; 7. Orthostatic syncope with loss of con-sciousness; 8. Low basal metabolic rate, —10 or lower; 9. Blood urea of 40 or more mg. per 100 c.c; 10. Pallor; 11. Secondary anemia; 12. False appearance of youth; 13. Neurologic signs. This disorder was first described in 1925 by Bradbury and Eggleston,1 and the literature, when reviewed in 1936 by Chew, Allen and Barker,2 revealed a total of 26 accepted cases. Although the number of cases is few, 13 cases have been reported from the Mayo Clinic.2 It is probable that many cases are over-looked and that many are not reported. The chief interest in this condition in the past has been in the cardiovascular manifestations. The neurologic features were commented upon by Chew, Allen and Barker,2 who found neurologic signs in 23 per cent of the cases. This did not include the case reported by Alvarez and Roth3 in which an undiagnosed illness, with features of a mild encephalitis preceded the onset of the orthostatic hypotension. In the five cases with neurologic signs there were no constant findings. Case 3 in the report by Bradbury and Eggleston 1 had inequality of the pupils, hyperactive tendon reflexes and a bilateral Babinski sign