CHEMISTRY OF THE ADRENALS (il7 



compounds whicli niifrht he fornicd in tlic body, that lia\'(> a i)r('.s.sor 

 effect, and which perhaps are formed, although not yet identified." 

 It is to be borne in mind that the formation of epinephrine is not hmited 

 to the ach'enals, but that other ishmds of cliromaffin sympathetic tissue 

 can do the same," which exphiins tlie oljserved discrepancies Ijetween 

 the anatomic changes in the adrenals and the clinical manifestations 

 of a deficiency in epinephrine. 



According to Goldzieher^'* the normal human adrenals contain to- 

 gether about 4 mg. epinephrine, which may be increased in conditions 

 with high blood pressure, such as arteriosclerosis and nephritis, in 

 whicli he found an average of 5.8 mg. ; and in septic conditions with 

 low pressure he found it reduced to an average of 1.5 mg.^" Lucksch^" 

 gives a normal figure of 4 mg. for each gland, also finding the amount 

 lowered in infectious diseases and increased in nephritis. The human 

 adrenal contains no epinephrine before birth, ""'^ but P'enger'^^ found it 

 present in the adrenal of unborn domestic animals. Autolysis of the 

 adrenal decreases the amount,®^ but not all of the epinephrine is 

 destroyed even several days after death, as shown by Ingier and 

 Schmorl,*^'' who, using both morphological and chemical methods, also 

 found a gradual increase in the epinephrine content of normal glands 

 from birth to the ninth year, after which it remains practically con- 

 stant at about 4.5 mg. (males 4.4, females 4.71 mg.). They also found 

 a slight increase in arteriosclerosis, more in acute and chronic nephritits 

 and a decrease in diabetes and narcosis, there being practically no 

 epinephrine in the adrenal of Addison's disease. In most of the in- 

 fectious diseases they found no changes, and in amyloid infiltration 

 the amount was about normal. The amount of chromaffin substance 

 and epinephrine do not always run parallel, although Borberg'"''' found 

 a close parallelism; this author also failed to observe any marked de- 

 crease of chromaffin substance in narcosis. Elliott** found a low 

 epinephrine content in acute infectious diseases, and especially low in 

 acute cardiac failure associated with great mental distress; he did not 

 find any increase in the epinephrine in nephritis or in any other disease. 



The function of the epinephrine is manifestly to modify the tone of 

 the non-striated muscle fibers which are under control of the sympa- 

 thetic nervous system, acting upon some receptive substance present 



5« See Barger and Dale, Jour. Physiol., 1910 (41), 19. 



" See Vincent, Proc. Rov. Soc, B, 1908 (82), 502. 



*» Wien. klin. Woch., 1910 (23), 809. 



59 See also Reich and Beresnegowski, Beitr. klin. Chir., 1914 (91), 403. Ohno 

 (Verh. Japan. Path. GeselL, 1916 (6), 15) found the normal content to be about 

 5.6 mg. averaging 8.32 mg. in chronic nephritis. 



«« Virch. Arch., 1917 (223), 290. 



" Moore and Purinton, Amer. Jour. Physiol., 1900 (4), 51; Julian Lewis, Jour. 

 Biol. Chem., 1916 (24), 249. 



62 Jour. Biol. Chem., 1912 (11), 489. 



63 Commessatti, Arch. exp. Path. u. Pharm., 1910 (62), 190. 

 «" Deut. Arch. klin. Med., 1911 (104), 125. 



« Skand. Arch. Physiol., 1912 (27), 341; 1913 (28), 91. 



