144 THE ADRENALS AND THE GENERAL OXIDATION PROCESSES. 



nessed in severe cases also typify the stage of marked poison- 

 ing: i.e., of suprarenal insufficiency. That this stage may 

 prove fatal is shown by some cases of so-called "retrocedent" 

 gout, in which the main symptoms, according to Osier, are 

 "pain, vomiting, diarrhoea, and great depression" or "cardiac 

 manifestations dyspnoea, pain, and irregular action of the 

 heart." In acute gout, immediately before an attack, "the 

 patient complains," says Levison, 14 "of headache, vertigo, 

 drowsiness, . . . cramps in the calves and elsewhere." He 

 also refers to "pain in the various articulations; parassthetic 

 sensations, such as numbness of the fingers, chilliness, etc.," 

 all signs which point directly to the suprarenal glands. We 

 can legitimately conclude, therefore, that the adrenals react 

 under the effects of the alloxuric ~bases precisely as they do under 

 those of any other toxic: i.e., toxins, mineral and vegetable poisons, 

 venoms, etc. 



Such is the process through which probably the most 

 active oxidizable poison produced in the organism is neutral- 

 ized. In a perfectly healthy subject the equilibrium of pro- 

 duction and destruction is constant, and the suprarenal glands 

 hardly, if at all, assert their presence through their character- 

 istic symptoms. A benign acid is produced and continu- 

 ously eliminated, the physiological cycle being performed with- 

 out interruption, and symptomatic fluctuations only occur when 

 increased tissue metamorphosis, as a result of exercise, diges- 

 tion, etc., bring on an increase of the physiological work of 

 which the adrenals are the primary source. Kindred reactions, 

 of which the oxidizing substance in the serum is probably the 

 basis, are brought about by the ingestion of certain fruits, 

 green gages, cranberries, and prunes, for instance, hippuric 

 acid being then found in the urine in greater quantities than 

 usual. 



The application of the physiological function of which the 

 oxidizing substance is the active agency to poisoning from 

 external poisons is well illustrated by the fact that, when cer- 

 tain agents or poisons are ingested, toluol, benzylamin, ben- 

 zoic acid, cinnamic acid, oil of bitter almonds, etc., the ex- 



14 Levison: Loc. cit. 



