THE ADRENALS IN DISEASE AND POISONING. 43 



nerves." In man "alarming depression" also occurs. Oxalic- 

 acid poisoning is stated to be attended with "entire prostration 

 of strength." Phosphorus poisoning also produces "a sense of 

 weakness and general wretchedness." Physostigma gives rise, 

 after the full therapeutic dose, to "slight weakness and dislike 

 for muscular exertion" and in large doses to "great muscular 

 weakness." "When an animal receives a small fatal dose of 

 Calabar bean, after a time muscular tremors appear, and al- 

 most immediately the victim falls to the ground or lies down 

 in a state of perfect muscular flaccidity." Santonin poisoning 

 is attended with trembling, which increases in severity until 

 convulsions occur. 



Silver was observed by Charcot and Ball 93 to cause, when 

 injected directly into the blood, sudden paralysis of the hind- 

 extremities. Strychnine in large doses produces "muscular 

 twitchings and startings and formications" while toxic doses 

 induce spasm, opisthotonos, etc. Muscular relaxation other 

 than that occurring between convulsions is not referred to, 

 though death during these periods of exhaustion are stated to 

 sometimes occur. Asphyxia caused by the "unyielding, spas- 

 modically-contracted muscles" doubtless occurs before the 

 stage of suprarenal insufficiency is reached, strychnine, of all 

 agents, standing prominently as the most active suprarenal 

 stimulant. Tobacco poisoning is stated to cause "absolute loss 

 of muscular strength" and finally complete collapse. Veratrine 

 is referred to as primarily a muscle-poison, a stage of hyper- 

 excitability preceding the stage of paralysis. Zinc poisoning 

 is attended with prostration. As to chronic poisoning by this 

 metal, Wood refers to the experiments of Sacher, 94 who found 

 that intravenous injections of very large doses of zinc salts 

 produced paralysis of the voluntary muscles. 



We thus have typified in all these various poisonous agents 

 not only the typical muscular weakness observed in recognized 

 diseases of the adrenals and the total prostration following re- 

 moval of the organs, but we can also discern in the list a series 

 of grades or degrees in the loss of muscular function ranging 



Charcot and Ball: Gazette Medicale, 1864. 

 M Sacher: Thesis, Dorpat, 1893. 



