THE ADRENALS IN DISEASE AND POISONING. 



55 



often, but not always, followed by an increase of the tempera- 

 ture of the surface/' This increase Delezenne explains by "the 

 supposition that the drug has the power of dilating the periph- 

 eral vessels." It now becomes evident that the only discrepancy 

 between the observations of Mosso and Delezenne is that the 

 latter used smaller doses of strychnine than the former, thus 

 producing central contraction and peripheral dilation, instead 

 of central dilation and peripheral contraction. Tobacco, 

 veratrum, and zinc show corresponding effects, and close the 

 list of agents whose temperature variations are considered 

 along with other toxic effects. All present a reduction of 

 peripheral temperature as a sign of advanced poisoning; none 

 show simultaneous central and peripheral hypothermia; sev- 

 eral incidentally prove that, when peripheral hypothermia is 

 present, there is simultaneous internal hyperthermia, thus 

 further sustaining the view that the effects on temperature 

 ascribed directly to drugs are of suprarenal origin. 



The symptoms just reviewed and with which those asso- 

 ciated with functional disturbances of the suprarenal glands 

 so accurately coincide, represent the most prominent ones 

 witnessed. There are several others, however, that are directly 

 traceable to these organs. Of these, dyspnoea seems to point 

 to so important a modification in the prevailing views respect- 

 ing the physiology of respiration that it will be treated in con- 

 junction with the latter function. 



Cerebral Activity. The reduction of cerebral activity 

 indicated by drowsiness, apathy, vertigo, coma, etc. seems 

 also to be at least partly of suprarenal origin. All drugs 

 capable of acting as toxics apparently produce effects in this 

 particular, corresponding exactly with those that follow re- 

 moval of both adrenals or advanced Addison's disease, after 

 giving rise to a period of excitement which also reproduces 

 that caused by injections of suprarenal extract. We thus have 

 again exemplified a period of suprarenal activity, followed by 

 one of insufficiency. Four drugs taken at random atropine, 

 alcohol, opium, and cannabis Indica will serve to illustrate 

 these facts. 



In atropine poisoning, the patient who, in the primary 

 stage was talkative, perhaps violent, and showed marked evi- 



