30 THE PHYSIOLOGY OF THE ADRENALS. 



cular coat and capillaries are antagonistic in contraction and 

 dilation" appears to us to be far reaching in its application. 

 Indeed, if the phenomena observed in Asiatic cholera, arsenic 

 poisoning, and other kindred conditions are recalled, the truth 

 of this assertion will appear. 



As a result of the central accumulation of blood, the ex- 

 tremities and peripheral tissues, more or less depleted of theirs, 

 are cold; the muscles, also deprived of the greater part of 

 their blood, lose their power; the tension upon the abdominal 

 vessels and neighboring structures, including the unusually 

 rich nervous net-works, produces the intense abdominal pain; 

 engorgement of the intestinal vessels gives rise to copious 

 diarrhoea, which by causing reduction of liquids tends to reduce 

 the renal secretion and sometimes to cause anuria. The de- 

 pletion of the cerebral vessels accounts for the syncope, and 

 the auto-intoxication, through accumulation of waste-products, 

 for the convulsions. All the symptoms of this terrible disease 

 thus seem to be accounted for and, we believe, for the first 

 time. They are precisely those that follow removal of both 

 adrenals. 



Still, while the various morbid conditions outlined account 

 for the symptoms recorded, closer investigation soon shows that 

 they are only satisfactory as far as they go, and that some 

 features of the symptom-complex are not fully met. Thus, 

 general relaxation of the vascular system means sudden in- 

 crease of caliber of all vessels, and, therefore, a corresponding 

 increase of area for the blood. Why should it, under these 

 circumstances, accumulate in the larger trunks? Why should 

 it not merely lie dormant in the relaxed vessels evenly dis- 

 tributed throughout them all? Again, gravitation prevails in 

 our body precisely as it does elsewhere. Why should the blood 

 not fill the vessels of the lowest levels of the organism and the 

 back, the nates, the calves, and the heels of the recumbent 

 patient become hypostatically congested, red, and hot, while 

 his toes, knees, abdomen, and face, blanched and cold, reveal 

 by their pallor and coldness the total absence of blood, which 

 has gone to find its level? Instead of this the entire surface is 

 frigid and blanched; the lowest portions of the body as well 

 as the uppermost show that all the peripheral capillaries are 



