88 THE ADRENALS AND THE RESPIRATORY BLOOD-CHANGES. 



murmurs and venous hums that are practically always ob- 

 served represent a striking feature of chlorosis. That they are 

 functional cannot be denied, since they usually cease when the 

 blood's haemoglobin shows an increase, as noted by Richard- 

 son 25 and others. That muscular relaxation of the cardiac walls 

 exists can also be shown. In a careful examination of 22 

 hearts Gautier 26 found 20 enlarged; this organ, as we have 

 seen, is the first to receive perfect blood from the lungs di- 

 rectly from the aorta through the coronaries; is it not plain 

 that deficiency of suprarenal secretion also causes muscular 

 relaxation of this organ? The lassitude and indisposition to 

 exertion are obviously of muscular origin and traceable to the 

 same cause. When we come to the most striking symptom of 

 chlorosis, the extreme pallor, suprarenal insufficiency again 

 suggests itself, since we not only have the blood-changes to 

 account for it, but also the contraction of the capillaries of the 

 surface caused by the simultaneous dilation of the abdominal 

 vascular trunks which the reduction of adrenal secretion in- 

 volves. The applicability of the postulate "Vessels supplied 

 with a muscular coat and capillaries are antagonistic in con- 

 traction and dilation" in this connection seems to us to 

 greatly strengthen the position taken. 



A review of the literature upon the absorption of iron 

 and particularly that bearing upon its intra vitam relations 

 with haemoglobin soon shows the correctness of Prof. H. C. 

 Wood's 27 remark that, "although a great amount of work has 

 been done by chemists upon the absorption and elimination of 

 iron, the results have been so imperfect, contradictory, and 

 difficult of explanation that they are at present of very little 

 use to the clinician." Bunge's view that iron is not absorbed 

 has steadily lost ground, and there is considerable available 

 evidence to show that absorption occurs. A. B. Macallum, 28 

 for instance, observed, in sections of intestines taken from ani- 

 mals first starved then fed upon a substance containing albu- 

 minate of iron, free leucocytes crowded with granules of iron 



25 Richardson: Lancet, June 27, 1891. 



* Gautier: Deutsch Archiv f. klin. Med., Bd. Ixii, H. 1 and 2, 



27 H. C. Wood: Loc. cit. 



28 A. B. Macallum: Jour, of Physiol., vol. xvi, 1894. 



