THE ADRENALS IN DISEASE AND POISONING. 53 



sufficient to keep up moderate peripheral capillary contraction, 

 with resulting impaired nutrition: the so-called "bromism." 

 Dougall's case, 109 in which 1 V 2 ounces of potassium bromide 

 was taken in 24 hours, affords a picture of total suprarenal 

 insufficiency, weak pulse, cold extremities, temperature of 96.8 

 F., general cutaneous anaesthesia, coma, etc. Camphor, classed 

 as an antispasmodic, is referred to as giving rise to "cool, 

 pale, and livid skin" in poisonous doses. Carbolic acid, classed 

 as antipyretic, was found by Hare 110 to produce a very distinct 

 fall of temperature in rabbits. Chloral, a somnifacient, is 

 referred to by Wood as follows: "A most remarkable action 

 of chloral is upon the temperature." In this particular all ob- 

 servers agree with Kichardson, of London, who has seen the 

 temperature fall 6 F. in a rabbit which recovered. Hammer- 

 sten observed a fall of 6 C. (Wood) in an hour in animals well 

 wrapped up and laid in a warm place. 



Chloroform furnishes a typical picture of suprarenal ac- 

 tivity followed by insufficiency. The central trunks, at first 

 contracted, produce engorgement of the peripheral capillaries, 

 causing facial congestion and suffusion, accompanied by cere- 

 bral excitement. When the dangerous stage comes on, the 

 contrary occurs: dilation of the central trunks depletes the 

 peripheral capillaries. The heart-muscle, more or less rapidly 

 deprived of the suprarenal secretion, gradually or suddenly 

 fails, according to the quantity of secretion furnished its walls. 

 These phenomena coincide with the temperature changes. 

 Simonin 111 "found that the temperature rises during the first 

 stage (1.1 to 0.9 C.), falls slightly during the second or re- 

 mains above normal, and falls decidedly during the third stage." 

 Cocaine, a "delirifacient," is stated to cause a "rise of rectal 

 temperature in cocaine poisoning, which sometimes amounts 

 to as much as 8 F." . . . "It is certainly not due to con- 

 vulsions," says Wood, "as it usually occurs before the motor 

 disturbance." Copper sulphate was found by Falck 112 to cause 

 great depression of temperature. Digitalis also lowers the tem- 



i Dougall: Glasgow Medical Journal, Feb., 1893. 

 Hare: Therapeutic Gazette, No. 519, 1887. 

 "i Simonin: Centralblatt fur Chirurgie, 234, 1877. 

 112 Falck: Deutsche Klinik, vol. xi, 1859. 



