610 CHEMICAL PATHOLOGY OF THE DUCTLESS GLAXDS 



be borne in mind that the formation of ei)inep]irin is not limited to tbe 

 adrenals, but that otlier islands of chromaffin sympathetic tissue can 

 do the same,^ which explains the observed discrepancies between the 

 anatomic chantres in the adrenals and the clinical manifestations of a 

 deficiency in epinephrin. 



Accordino- to Goldzieher ^ the normal human adrenals contain to- 

 gether about 4 mg. epinephrin, which ma}' be increased in conditions 

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

 which 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.*^ The 

 human adrenal contains no epinephrin before birth,"' but Fenger ^ 

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

 of the adrenal decreases the amount,' but not all of the epinephrin 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 epinephrin 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 nephritis, 

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

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

 tious diseases they found no changes, and in amyloid infiltration the 

 amount was about normal. The amount of chromaffin substance and 

 epinephrin 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 

 epinephrin 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 epinephrin in nephritis or in any otlier dis- 

 ease. 



The function of the epinephrin 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 

 in the muscle, perhaps at the nerve endings. But it is a fact of much 

 practical importance that administration of epinephrin will not com- 

 pensate successfully for the loss of the adrenals, whether because the 

 gland secretes other things, or because the intermittent artificial ad- 

 ministration of the epinephrin will not compensate for the regulated 



3 See Vincent, Proc. Ro.y. Soc., B, 1908 (82), 502. 



4Wion. klin. Wooh., 1010 (23), SOn. 



•1" See also Keicli and Bcresne-j^owski, T?eitr. klin. Chir.. 1!)14 (91), 40.'^. Oliiui 

 (Verb. .Japan. Palli. riescll., lOKJ (('.). l.'j) found tlie normal content lo ho ahout 

 5.0 mg., averai,nn<r S.32 inj,'. in clironic nei)liritis. 



■'■' Moore and Pnrinton, Amor. Jo;:r. Plivsioi., 1!)00 (4). 51 ; .Fulian Lewis .Tour 

 Biol. Cliem.. 1010 (24), 240. 



'i.Ioiir. Biol, ('hem., 1012 (II), 480. 



7 C'omeHKJitti, Areli. exj). Palli. u. Pliarm., 1010 (02), 100. 



M)eut. Aroh. klin. :Med.. 1011 (104), 125. 



y Skand. Arcli. Plivsiid,, 1012 (27), 341; 101.3 (28). 01. 



