ADRENAL INSUFFICIENCY AND BLOOD-DISINTEGRATION. 105 



tion, which, as we now know, is constantly being supplied to the 

 body, is oxidized in the course of the respiratory process. 



In the light of all that has already been said concerning 

 the effects of stimulation on the adrenals and the signs of 

 insufficiency, the symptoms that follow amyl-nitrite inhalations, 

 as described by Professor Wood, clearly depict the course of 

 events. "The most prominent symptoms induced when amyl 

 nitrite is inhaled by a man in moderate quantities," says this 

 author, "are a sense of great fullness and distension of the 

 head, amounting at last to severe pain and accompanied by 

 intense flushing of the face." We can easily recognize here 

 the result of a sudden spurt of suprarenal activity. The cen- 

 tral vascular trunks and all the muscular vessels, veins, etc., 

 are suddenly contracted, while the peripheral capillaries are 

 dilated, giving rise to the cerebral pressure, the flushing, etc. 

 That this dilation occurs independently of the spinal cord is 

 sustained by the experiments of Wood and Lauder Brunton, 

 which showed that its division did not prevent the peripheral 

 congestion. "A deep, labored respiration, an exceedingly rapid 

 and violent action of the heart," are next referred to, but the 

 line where suprarenal insufficiency begins is not clearly de- 

 fined evidently, since, to use Wood's words, "the succession 

 of these phenomena is usually so rapid that often they seem 

 to be simultaneous." 



Yet we have precisely at this point additional testimony 

 that we must be dealing with suprarenal secretion, since Wood 

 remarks: "But it is said that the cardiac disturbance is some- 

 times very distinctly manifest before the other symptoms." We 

 have seen that the heart is the first organ reached by the secre- 

 tion, and it must therefore be first to receive the brunt of the 

 suprarenal principle. These facts are also sustained by the 

 experiment of Bock on an isolated mammalian heart, which 

 showed that nitrite of amyl has no effect upon the heart itself. 

 The stage of suprarenal insufficiency is strikingly described: 

 "After poisonous doses," continues Professor Wood, "the symp- 

 toms have been great pallor; usually dilation, but sometimes 

 contraction, of the pupils; excessive muscular relaxation; slow, 

 scarcely perceptible pulse; haemoglobinuria, and irregular res- 

 piration." The morbid effects of suprarenal insufficiency i.e., 



