138 THE INTERNAL SECRETIONS—1920 
found instead of a hypotension; this is also true of 
several chronic conditions, especially those involving 
the kidneys and heart, and in some cases of poisoning, 
as from lead. 
The chill and rise of temperature mentioned above 
are due to the reaction of the system to the toxins 
produced, by the growth and metabolism of the invad- 
ing bacteria. It may be that these toxins stimulate 
the adrenal glands directly, and these, as a result, soon 
throw out their specific hormones more abundantly. 
The adrenal medullary secretion acts on the muscle tis- 
sue of the heart and of the blood vessels, causing con- 
traction, resulting in an increased blood pressure. It 
has been proved that the blood pressure rises and falls 
in direct proportion to the amount of adrenal secretion 
in the system. Another theory regarding the adrenal 
response in such circumstances, which may seem as 
good to some, is that the system, finding itself invaded 
by the toxins, automatically brings into play certain 
nervous stimuli which increase the adrenal secretion; 
but however it comes about, we know that this increase 
persists for a time at leasat. 
We have known for years that the initial increase 
of blood pressure in infectious diseases was an effort 
on the part of nature to produce greater detoxication 
and elimination. Later, the heart and the blood vessels 
seem to lose tone and the system is unable to maintain 
the blood at its higher pressure, and we find at times, 
with this decrease, that the organism cannot keep up 
the proper excretion of toxins, and, unaided, it would 
be but a matter of time in many cases when the patient 
would be overcome by them. Whether the resultant 
accompanying hypoadrenia is caused by a lack of se- 
creting action of the adrenal glands, or a leak from the 
system of this secretion, is a mooted question; but we 
know that the lack exists, because by supplying the 
adrenal secretion, or the gland substance itself, the 
