138 THE INTERNAL SECRETIONS 1920 



found instead of a hypotension; this is also true of 

 several chronic conditions, especially those involving 

 the kidneys and heart, and in some cases of poisoning, 

 as from lead. 



The chill and rise of temperature mentioned above 

 are due to the reaction of the system to the toxins 

 produced, by the growth and metabolism of the invad- 

 ing bacteria. It may be that these toxins stimulate 

 the adrenal glands directly, and these, as a result, soon 

 throw out their specific hormones more abundantly. 

 The adrenal medullary secretion acts on the muscle tis- 

 sue of the heart and of the blood vessels, causing con- 

 traction, resulting in an increased blood pressure. It 

 has been proved that the blood pressure rises and falls 

 in direct proportion to the amount of adrenal secretion 

 in the system. Another theory regarding the adrenal 

 response in such circumstances, which may seem as 

 good to some, is that the system, finding itself invaded 

 by the toxins, automatically brings into play certain 

 nervous stimuli which increase the adrenal secretion; 

 but however it comes about, we know that this increase 

 persists for a time at leasat. 



We have known for years that the initial increase 

 of blood pressure in infectious diseases was an effort 

 on the part of nature to produce greater detoxication 

 and elimination. Later, the heart and the blood vessels 

 seem to lose tone and the system is unable to maintain 

 the blood at its higher pressure, and we find at times, 

 with this decrease, that the organism cannot keep up 

 the proper excretion of toxins, and, unaided, it would 

 be but a matter of time in many cases when the patient 

 would be overcome by them. Whether the resultant 

 accompanying hypoadrenia is caused by a lack of se- 

 creting action of the adrenal glands, or a leak from the 

 system of this secretion, is a mooted question ; but we 

 know that the lack exists, because by supplying the 

 adrenal secretion, or the gland substance itself, the 



