774 INTERNAL SECRETIONS AND PRESERVATION OF LIFE. 



We have seen how dependent upon the adrenal functions 

 arethose of the heart. Even if the nutrient cells, the neutro- 

 philes, and the haemoglobin cells, the eosinophiles, were sup- 

 plied in sufficient numbers (leucocytogenesis being inadequate 

 when adrenal Insufficiency exists), what would it avail with a 

 weak heart to send them through their distributing channels? 

 Indeed, what there is produced of adrenal secretion, life's pabu- 

 lum, we may say, cannot even pass the alveoli with sufficient 

 speed to adequately supply not only the system at large, but 

 the pulmonary tissues themselves with oxygen. Indeed, we have 

 seen that the activity of function in any organ was commen- 

 surate with the speed with which the oxidizing substance passed 

 through that organ. That this also applies to the lungs is 

 strikingly illustrated by the beneficial effects of high altitudes, 

 which, by enforcing a marked increase of cardiac activity, pro- 

 portionally enhance general nutrition, not only of the lungs, 

 but also that of the adrenal system itself. 



But the predominating feature of the morbid process as 

 regards systemic vulnerability to the disease is that connected 

 with the protective functions in the alveoli. Since our study of 

 the subject in the eleventh chapter was submitted, we ascer- 

 tained that all three varieties of adult leucocytes are present in 

 this most exposed portion of the organism, and that they all 

 contain trypsin. As this substance is ejected with their gran- 

 ules, the eosinophiles, in undergoing conversion into nucleated 

 epithelium, doubtless eliminate theirs along with their large 

 haemoglobin granules. The cavity of the lobule and the under- 

 lying serum must therefore be constantly supplied with this 

 bactericidal and antitoxic fluid (besides the phagocytic neutro- 

 philes), when the adrenal system is functionally normal. 



Absolute integrity of the adrenal system thus asserts itself 

 as a sine qua non of perfect immunity against pulmonary tuber- 

 culosis, i.e., against the intrusion of pathogenic germs of any 

 kind (and particularly the tubercle bacillus) in the circulations, 

 not only of the lungs, but also of the intestines. We say "cir- 

 culations," because the lymph is at least as greatly exposed 

 to invasion as is the blood, and is a far better medium for the 

 rapid pullulation of bacteria. Insufficiency of the adrenal sys- 

 tem, whether inherited or acquired, when sufficiently advanced 



