48 THE PHYSIOLOGY OF THE ADRENALS. 



between the suprarenal insufficiency induced and the arrest of 

 the heart is apparent. Camphor is referred to as acting directly 

 as a stimulant to the heart-muscle. Interesting, however, is 

 Professor Wood's reference to the contrary results reached by 

 Alexander Lewin, 103 which he ascribes to "the use of over- 

 whelming doses, camphor first stimulating and then depressing 

 the heart-muscle." Carbolic acid he refers to in the following 

 words: "The prominent symptoms induced by lethal doses are 

 disturbance of respiration; stupor, deepening into coma; rapid, 

 feeble pulse; muscular weakness; abolished reflexes; collapse; 

 fall of temperature, and albuminous or bloody urine, etc." It 

 is perhaps necessary to point to these phenomena as the exact 

 counterpart of total suprarenal insufficiency. Chloral at first 

 causes slowing of the heart's action. "Very large doses," ac- 

 cording to both Andrews and Da Costa, 104 "decidedly lessen 

 arterial pressure. The characteristic influence of therapeutic, 

 and still more of toxic, doses is to produce a fall in the blood- 

 pressure, usually accompanied by a lessening in the frequency 

 of the heart's action." 



The preliminary stimulation of cardiac action induced by 

 chloroform is well known. "Putting all the evidence together," 

 writes Wood, "it seems to us to have been completely demon- 

 strated by physiologists, first, that chloroform is a direct de- 

 pressant and paralyzant to the heart-muscle or its contained 

 ganglia; second, that the fall of blood-pressure which occurs 

 in chloroformization is in great part due to this direct depres- 

 sion of the heart." Cocaine, as shown by various investigators, 

 produces an increase of arterial pressure when given in mod- 

 erate doses. "The drift of the present evidence," says Wood, 

 "is to show that the small dose of cocaine moderately stim- 

 ulates the heart, and that the large, toxic dose finally depresses 

 it." 



Copper is another agent the clinical phenomena of which 

 recall those of cholera: toxic doses paralyze the heart in lower 

 animals. Digitalis, in batrachians, raises blood-pressure and 

 depresses it in the last stage. "In most of the experiments of 



108 Alexander Lewin: Archiv fiir exp. Path., etc., 1890. 



104 Andrews and Da Costa: American Journal of the Medical Sciences, April, 

 1870. 



