ADRENAL HYPOFUNCTION 161 



Dr. B. G. Pinkerton of Los Angeles. In August, 1918, 

 D. R., age 18, one Monday night suddenly developed a 

 fever of 104, which by Tuesday noon subsided to 97 de- 

 grees. The boy was delirious continuously from the 

 onset. Tuesday afternoon he began to vomit and have 

 involuntary urination and defecation. One consultant 

 suggested an early tuberculous meningitis; another 

 suggested thrombosis of the lateral sinus, or perhaps a 

 brain abscess. Wednesday morning brought no change. 

 At 9 A. M. Wednesday I saw the patient and found the 

 above condition, with temperature 97 degrees, pulse 

 140, systolic blood pressure 90 mm. The urine con- 

 tained both albumin and casts, with plenty of acetone. 

 My diagnosis was acute adrenal exhaustion from the 

 acidosis. Adrenalin-chloride and Kalak water were 

 given by mouth, with a solution of bicarbonate of soda 

 and sodium chloride by rectum, by the Murphy drip 

 method. This regimen soon changed the whole picture. 

 By 5 P. M. the pulse was 110, the systolic pressure 100 

 mm., with a cessation of the vomiting and lessening of 

 the delirium. The next morning the pulse was 76, sys- 

 tolic pressure was 120, temperature 98.6, and the boy 

 wanted to go home. If that boy had been anesthetized 

 and an operation performed for sinus thrombosis, what 

 chance would he have had for recovery? 



THE RELATION OF THE MINERAL METABOLISM 



The subject of acidosis is closely allied to demineral- 

 ization. The adrenals, and, in fact, all the ductless 

 glands, must have the proper amount of the proper 

 mineral salts in the plasma for their perfect function- 

 ing. Hypoadrenia, then, also means demineralization, 

 and adrenal feeding will not accomplish much unless 

 we supply these minerals also. Stheeman (14) has 

 shown, using the method of De Waard, that the calcium 

 content of the blood is low in neuroses of the vegetative 

 nervous system, universal asthenia, and tuberculosis; 



