THE ADRENALS AND CHLOROSIS. 87 



or fail to be taken up by it. We already have reason to believe 

 that this occurs in the lungs, and, haemoglobin being the pre- 

 dominating factor in this connection, analysis of the conditions 

 that compromise the integrity of the haemoglobin molecule in 

 the lungs will doubtless furnish some clue to the nature of 

 the process involved. 



THE ADRENALS IN THEIR RELATION TO CHLOROSIS. 



Hemoglobin not only requires iron for its elaboration, 

 but this metal constitutes by far its most striking character- 

 istic. It cannot be formed without iron any more than the 

 chlorophyl of plants can be formed without it. Again, since 

 the power of haemoglobin to take up oxygen depends upon the 

 proportion of this ingredient, a sufficiently great ratio both of 

 iron and of the pigments with which it enters into association 

 must be present to insure normal functions, all other features of 

 the process being adequately carried out. The almost unfail- 

 ing beneficial effects of iron in chlorosis are well known. We 

 are led to believe, therefore, that chlorosis is mainly due to 

 a deficiency in the quantity of iron taken into the organism 

 or to the imperfect assimilation from animal foods, etc. 



Yet there are many phenomena of chlorosis that are not 

 satisfactorily accounted for and which the known physiological 

 properties of the suprarenal secretion seem to readily explain. 

 Thus, the gastric symptoms, so marked in practically all cases, 

 are easily understood when the effects of suprarenal extract on 

 muscular tissue are recalled. Moreover, the close relationship 

 between the first artery of the cceliac axis and the stomach, on 

 the one hand, and the origin of the cceliac axis from the aorta 

 which contains freshly adrenalized blood on the other, all 

 previously referred to, show how direct is the connection be- 

 tween the adrenal secretion and the gastric muscular walls. 

 What is more clearly accounted for by this physio-anatomical 

 distribution than the gastric dilation and gastroptosis con- 

 stantly observed in these cases: i.e., when relaxation of the 

 muscular walls, due to deficiency of suprarenal secretion, is 

 introduced as a cause? That in all other diseases in which 

 suprarenal insufficiency prevails gastric disorders are more or 

 less marked further confirms this fact. Again, the cardiac 



