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Reliability of the Methacholine (Mecholyl) Test:  Variation in Results When Performed upon the Same Patient by Different Examiners

JAMES W. MAAS, MC
AMA Arch NeurPsych. 1958;79(5):585-589. doi:10.1001/archneurpsyc.1958.02340050113014.
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Introduction  In 1950 Funkenstein, Greenblatt, and Solomon1 published their work with the epinephrine-methacholine (Mecholyl) test and its relation to prognosis with electroshock therapy (EST). In 19522 they further reported that prognosis could be predicted with the use of methacholine alone; i. e., those patients whose systolic blood pressure did not return to a basal level 25 minutes after injection with methacholine (a Type-6 curve) had a good prognosis with EST, as did those in whom the drug produced a chill and either relieved or precipitated severe anxiety. In further work 3,4 these authors felt that the type of response was perhaps related to the secretion of epinephrine-like and arterenol-like substances—the former associated with "anger in" and failure to establish homeostasis, the latter with "anger out" and the return of the systolic blood pressure to at least the preexisting basal level. Further acceptance of the above assumption was brought

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