74 THE PHYSIOLOGY OF THE ADRENALS. 



or deadened by a lack of oxygen. But these, as yet, are matters 

 of speculation." 



The clinical evidence which could be adduced to emphasize 

 a relationship between the respiratory functions and the ad- 

 renals is very great. Several of the more prominent symptoms 

 of the algid stage of Asiatic cholera, for instance, when con- 

 sidered collectively, cyanosis of the extremities and face, in- 

 creased frequency of the respiratory movements and dyspnoea, 

 etc., point to the lungs as the seat of morbid phenomena. 

 Cyanosis obviously denotes insufficient oxygenation whatever 

 be its cause, while imperfect oxygenation in turn implies an 

 increase of the carbonic-acid ratio. That this gas accumulates 

 in the organism during cholera has been demonstrated. The 

 connection is further suggested by the symptoms that follow 

 extirpation of suprarenal glands in mammals; so closely do 

 they resemble those of Asiatic cholera as to suggest that we 

 have in this disease the characteristic symptom-complex of 

 arrested suprarenal function. Besides the general manifesta- 

 tions, which will be reviewed later on, those pertaining to gen- 

 eral vital processes, oxygenation, temperature, etc., are similar 

 in both conditions. Both show great reduction of vascular 

 pressure, with consequent small and rapid pulse, while both 

 are alike attended by "increased frequency of the respiratory 

 movements, dyspnoea, and often cyanosis and subnormal tem- 

 perature" during what might be termed the algid stage of both 

 morbid states, which are also similar in this particular. If, 

 then, the symptoms referred to are traceable to the lungs in 

 cholera, we are warranted, we think, in ascribing those that 

 occur after extirpation of the adrenals also to the lungs. Espe- 

 cially is this permissible since we are led to the lungs for a 

 reaction which the chemical properties of the adrenal secretion 

 render possible, and since they are so anatomically disposed as 

 to make it possible to distribute the charged blood, through the 

 agency of the heart, to all the tissues of the organism. 



Indeed, the more the inquiry progresses in this direction, 

 the more does it become evident that an important relation- 

 ship exists between the suprarenal and the pulmonary func- 

 tions. A striking feature is the apparent exemption of the 

 pulmonary tissues to the effects of suprarenal secretion. Wai- 



