THE ADRENALS IN DISEASE AND POISONING. 39 



occupied by the adrenals in pathology when he adds: "Fatty 

 change does not give rise to any symptoms." 



If the views herein recorded are not erroneous, it would 

 seem far more exact to state that fatty change of the adrenals 

 represents an end-result of almost all morbid processes attended 

 with the introduction into the blood of a toxic, whether this be a 

 vegetable or mineral poison, a toxin, a catabolic product, a venom, 

 etc., any agency in fact, extrinsic or intrinsic, capable of induc- 

 ing what we now term a "toxaemia." Another deduction which 

 logically suggests itself is that all the major symptoms now 

 ascribed to the direct action of all these toxics are primarily 

 ascribable to their morbid effects upon the adrenals, either 

 directly upon the organs themselves or indirectly upon them 

 through a primary action upon the centers of their nervous 

 supply. In other words, it would appear that all major symp- 

 toms witnessed in diseases in which the blood is invaded by a poison 

 are in reality manifestations of overactivity, insufficiency, or total 

 inactivity of the adrenals. 



The latter conclusion, however, imposes as conditions that 

 all poisons give rise to similar symptoms, due allowance being 

 made for the differences in power as represented by the activity 

 of an agent plus the dose administered, and that these symp- 

 toms precisely coincide with those of suprarenal insufficiency 

 or those which follow removal of both adrenals. That such is 

 the case is shown below. 



EFFECTS OF VENOMS, VEGETABLE AND MINERAL POISONS 

 ON THE ADRENALS. Removal of both organs, as we have seen, 

 is followed by extreme muscular weakness, marked reduction 

 of blood-pressure, hypothermia, dyspnoea, and blood-changes. 

 All these phenomena should appear under the influence of suf- 

 ficiently active poisons if the above conclusion is warranted. 



To strengthen the evidence adduced only works will be 

 used for comparison in which the observations given in no way 

 refer to the suprarenal glands. For the study of venoms we 

 are fortunate in having at our disposal a comprehensive and 

 admirable article by J. Noe, 85 of Paris, which gives a complete 

 retrospect of all the main investigations upon this subject dur- 



85 J. No6: Archives G6n6rales de M6decine, Jan., Feb., Sept., and Nov., 1899. 



