160 THE INTERNAL SECRETIONS 1920 



more she worried, the worse she felt. July 15th, 1920, 

 blood and spinal fluid showed negative Wassermann 

 tests. The use of adrenalin, by mouth, served to homo- 

 stimulate the adrenals and cause the disappearance of 

 all symptoms, before the blood and spinal fluid tests 

 were made. 



The effect of focal infection upon the activity of the 

 adrenals is nicely shown in the following case : An old 

 man, age 70, was seen a year ago with Dr. J. R. Perry, 

 of Sherman, California. His blood pressure had been 

 elevated to 196 mm. The doctor found some pus teeth, 

 and advised their removal. This was done, and in two 

 weeks blood pressure fell to 136 mm., systolic, but at the 

 same time he developed "spells" lasting ten to fifteen 

 seconds, during which time he apparently was semi- 

 conscious. These spells were always preceded by a 

 chewing movement of the face and jaw muscles. Jack- 

 sonian epilepsy was suspected by the attending physi- 

 cian. Systolic blood pressure was now 136 mm. recum- 

 bent, but was only 100 mm. erect. Sergent's white line 

 was also present. Adrenal hypof unction was my diag- 

 nosis. I reasoned that the toxins from the pus teeth 

 had served to irritate and stimulate the adrenals ; when 

 these toxins were no longer formed, the excessive stim- 

 ulation ceased, and there was a depression following. 

 Adrenal gland with thyroid, spermin and calcium were 

 given, with the prompt recovery and return to ranch 

 life in about a month. 



SEVERE, ACUTE HYPOADRENIA 



In the acute cases there has been either of the fol- 

 lowing: (a) violent injury, (b) severe hemorrhage, 

 (c) overwhelming infection and intoxication, (d) se- 

 vere psychic shock or, finally, (e) acute acidosis. I am 

 convinced that many deaths on the operating table are 

 due to acute hypoadrenia, overlooked by the surgeon. 



I wish to relate my experience with a case seen with 



