THE ENDOCRINE ORGANS, OR DUCTLESS GLANDS 773 



tissue forming the wall of the inksac in the cuttle fish will, upon the ad- 

 dition of tyrosine, produce a sepia pigment. Halle's hypothesis, then, 

 implies that the tyrosine which under normal circumstances would be 

 employed for the manufacture of epinephrine, is, in the case of adrenal 

 deficiency converted into pigment. Attractive though this hypothesis may 

 be, it should be pointed out that Ewins and Laidlaw 8 have failed to con- 

 firm it. 



In addition to this chronic form of adrenal disease cases of acute 

 adrenal insufficiency occur. Death, which very rapidly ensues, may be 

 preceded by symptoms of cerebral hemorrhage, or acute abdominal dis- 

 ease or may follow a short period of extreme myasthenia. In other in- 

 stances death is sudden and unheralded, and that the adrenals are re- 

 sponsible is revealed by finding that they are the seat of extensive disease. 

 This may be manifested by areas of necrosis, by hemorrhage or by ve- 

 nous thrombosis. In a case reported recently by Boyd, 9 the subject, 

 prior to the rapidly fatal attack, was in apparently good health. An 

 autopsy showed the medullary tissue to be entirely consumed by a process 

 of long standing, whereas the cortex was the seat of an acute lesion which 

 apparently was the cause of the fulminating symptoms. 



Suprarenal Extracts Preparation 



Injection, particularly intravenous, of extract of the adrenal gland 

 has furnished us with most of the evidence upon which our knowledge 

 regarding the function of this organ depends. Such an extract is best 

 made by grinding the entire gland with fine sand in a mortar and then 

 extracting with a weak (decinormal) solution of hydrochloric acid. The 

 extract may then be boiled, filtered through muslin and nearly neutral- 

 ized, preferably by means of sodium acetate. If kept in this acid reac- 

 tion, the active principle of the extract does not materially deteriorate 

 with time, but if it be neutralized or considerably diluted, destruction 

 due to oxidation occurs, as evidenced by a distinct browning of the 

 solution. The active principle of such extracts has been isolated in a 

 crystalline form (Takamine and Abel). It has been given various names 

 (adrenalin, suprarenin, adrenin, etc.), but the tendency is definitely 

 towards the use of epinephrine. Chemically, epinephrine has been found 

 to be orthodioxyphenylethylolmethylamine. 



HO 



N -*CH(OH) -CH 2 NHCH 3 . 



It will be noted that it is closely related to tyrosine (see page 639). It 

 is also closely related to a group of substances (amines) occurring in 

 putrid meat and to which the active principles of ergot belong. It 



