ORGANOTHERAPY AND THE ADRENALS 169 
there is a sympatheticotonic paroxysm. During the 
second phase the clinical and pathogenic phenomena 
are very like those of shock. 
Cazamin remarks that people inclined to sympatheti- 
cotony are peculiarly predisposed to seasickness, while 
the vagotonic escape. 
In the second phase, adrenalin, by mouth (the equiv- 
alent of 6 mg. in three doses at half-hour intervals), 
gives good results. 
During the stage of hyperadrenia he has obtained 
absolutely constant, excellent results, both in preven- 
tion and in curing the seasickness, from hypodermic 
injections of neutral sulphate of atropin in doses vary- 
ing from 0.001 to 0.002 gms. 
As we know of no dependable drug that will check 
the functioning of the sympathetic nervous system, the 
next best thing is to act on the antagonistic nervous 
system. By influencing the vagus in this way with 
atropin, we thus indirectly control the sympathetic. 
The question whether adrenalin or atropin is called for 
is easily answered by the oculocardiac reflex. His ex- 
perience indicates that with one or the other of these 
drugs we can ward off and cure practically every case 
of seasickness. 
Another interesting class of cases comes to mind. 
Many times the form of paroxysmal tachycardia, which 
depends upon an imbalance between the thyroid and 
adrenals, with a moderate excess of thyroid secretion, 
may yield to a few doses of adrenalin in a very grati- 
fying way. There are few services for which the pa- 
tient is more grateful than to have the pounding heart 
quieted down. The same remedy is almost a specific 
for the insomnia associated with this form of endocrine 
disturbance. Recognition of this factor will save hours 
of sleep to the patient. 
The manifold uses and great therapeutic value of 
adrenal extracts are, perhaps, more readily understood 
