Some Observations on the Treatment of Ulcerative Colitis with A.C.T.H

fulminating type of ulcerative colitis. Pessel and others (1953) report a fatal case of multiple bowel perforations and peritonitis occurring during treatment with A.C.T.H. It is therefore interesting to note that in the present study the only two cases of perforation of the bowel occurred in patients of the control group. One patient who was receiv- ing large doses of cortisone had a massive haemorrhage from the bowel. Other less serious complications were fairly frequent in both the cortisone and the control group, and will be discussed in detail in the final report. We do not, as yet, know whether the patients treated with cortisone will show any lasting benefit over the subsequent course of time. A small number of the patients treated with cortisone relapsed shortly after the cessation of treatment, but not enough to alter materially the general picture of its beneficial effects. We are attempting to follow the long- term progress of all patients who have been included in the trial, so that this point may eventually become clear. It is already known that some patients may relapse and need further courses of treatment in the future. It seems likely that some patients will require continuous treatment with cortisone to maintain their improvement, but the efficacy of long-continued treatment remains to be determined.