BLOOD-DISINTEGRATION AND POISONS. 95 



corpuscles first occurs, and, according to Osier 48 : "In some 

 instances the globular richness rises above normal." The ad- 

 renals which, as we have seen, are merely physiologically 

 deficient (in most cases), through impaired nutrition, their pro- 

 toplasm failing to receive from the imperfect blood coursing 

 through them sufficient elements for the creation of a perfect 

 secretion or enough of it soon increase their activity. Better 

 nourished, their secretion improves in quantity and power and 

 more iron is assimilated and fixed in the formation of haemo- 

 globin: a phase of improvement which, of course, requires some 

 time. "The increase of haemoglobin/' says Osier, "is slower, 

 and the maximum percentage may not be reached for a long 

 time." Arsenic also cures some cases; this agent is particularly 

 active as a suprarenal stimulant and the symptoms following 

 a poisonous dose are those of cholera: i.e., those following 

 removal of both adrenals. As regards iron, V. H. Meyers and 

 F. Williams 49 state that "both frogs and mammals are killed 

 by it, the symptoms in warm-blooded animals being vomiting, 

 purging, great fall of blood-pressure, muscular weakness, and 

 finally coma and death." A more clearly defined list of the 

 effects of double adrenalectomy could not be presented. Hence, 

 iron must directly stimulate the adrenals in chlorosis in addi- 

 tion to its role as a structural constituent of the haemoglobin- 

 molecule. 



THE ADRENALS IN THEIR RELATION TO BLOOD-DISINTEGRA- 

 TION UNDER THE INFLUENCE OF POISONS. 



Haematuria i.e., the presence of blood in the urine 

 follows injections of suprarenal extract, and therefore typifies 

 overactivity of the adrenals. The experiments of Swale Vin- 

 cent, among others, have demonstrated the effects of supra- 

 renal-extract injections in this connection, "blood-colored 

 urine" and "bleeding from the mouth and nostrils" in guinea- 

 pigs and rats having been produced by this agent. These fully 

 illustrate the influence of pressure in the capillaries brought on 

 by contraction of the central vascular trunks. 



48 Osier: "Practice of Medicine," p. 801. 



49 V. H. Meyers and F. Williams: Archiv fur Exper. Path. u. Pharm., Bd. 

 xiii, 1876; quoted by Wood, p. 418. 



