50 THE PHYSIOLOGY OF THE ADRENALS. 



tended with pronounced cardiac weakness, even in the primary 

 stage. "The patient," says Wood, "may suddenly succumb to 

 collapse and cardiac paralysis." Physostigma, injected in poi- 

 sonous doses into the jugular vein, causes death from syncope 

 or from simultaneous "failure of the cardiac and respiratory 

 functions, and the heart is arrested in diastole. When smaller 

 doses are exhibited, there is slowing of the heart's action." 

 Santonin in toxic doses causes slowing of the pulse in dogs, and 

 rapid or slow, feeble pulse in children. Silver salts when in- 

 jected into the veins were found by Charcot and Ball, Rabuteau 

 and Mourier to cause instantaneous death, which is ascribed 

 by these investigators to "a direct paralyzing influence of the 

 drug upon the muscle of the heart." Strychnine is stated by 

 Wood to produce in full dose "a rise of the arterial pressure, 

 which is enormously increased during the convulsion, after 

 which there is a very pronounced fall in the arterial pressure." 

 Tobacco, or rather its alkaloid, nicotine, is referred to as hav- 

 ing "a very distinct influence" upon the circulation, "produc- 

 ing, first, rise, and afterward fall, of pressure." Veratrine, even 

 in small doses, causes slowing and weakening of the pulse, and 

 a toxic dose has produced collapse, with rapid, thready, and 

 irregular pulse. The toxic effects of zinc are similar to those 

 of copper referred to above. 



This long list of toxics can be said to fully indicate, first, 

 that all poisons primarily induce a more or less marked period 

 of overactivity: i.e., increased vascular pressure and cardiac 

 energy. The central vascular trunks are suddenly contracted, 

 the heart is stimulated by the direct action of an unusual 

 amount of suprarenal secretion. Second, that at a given time 

 and when the dose and power of the toxic are sufficiently 

 great, this increase of activity ceases and is replaced by a more 

 or less marked decrease of vascular pressure and cardiac energy. 

 The central vascular trunks are then dilated and the heart- 

 action reduced through a corresponding reduction of suprarenal 

 secretion. 



Temperature. A marked reduction in the temperature, 

 we have seen, is a prominent symptom of advanced supra- 

 renal insufficiency. The symptomatology of all forms of 

 poisoning also includes this phenomenon. As to venoms, 



