ADDISON S DISEASE 343 



forms adrenalin from the aromatic split products of albumin, tyrosin, and 

 phenylalanin or oxyphenylserin (Halle, Frankel, Friedmann). 



Of the chemical methods for demonstrating adrenalin we will mention 

 only the iron chloride test (Vulpian), the sublimate test (Comesatti), the 

 iodine reaction (Vulpian, Schur, Frankel, and Alters}, the potassium perman- 

 ganate lactic acid test (Zanfrognini). 



I shall limit myself to sketching briefly the most important of adrenalin's 

 physiological actions. It acts as a powerful increaser of the blood-pressure 

 through narrowing of the peripheral vessels, it mostly acts first by slowing 

 the pulse, then accelerating the pulse; it slows the pulse by reflex excitation 

 of the vagus center, this action belonging to the so-called by-activities 

 [Nebeneinwirkungen] of adrenalin (Biedl) . Other by-activities are the shal- 

 lowing of respiration, and, according to Biedl perhaps also the increase of 

 the excitability of the striated muscles. It acts in a relaxing manner on the 

 stomach and intestines, as a contracting agent on the three sphincters (the 

 pyloric, and ileo-colic, and the internal sphincter of the anus). The uterine 

 muscle is contracted or relaxed by adrenalin, according to whether the 

 pressor [fordernden] or the inhibitory fibers predominate or are excitable 

 (Falta and Fleming). Probably the bladder behaves in the same manner. 

 Under circumstances mydriasis occurs. The vessels of the kidneys react to 

 minimal doses by dilatation and diuresis (Jonescu). Under circumstances 

 adrenalin may produce salivation and secretion of tears, indeed in large 

 doses (in guinea-pigs) , also secretion of sweat (Falta and Ivcovic) . Adrenalin 

 produces hyperglycemia and glycosuria (F. Blum, Metzger, and Zultzer) . The 

 hyperglycemia comes about by mobilization of the glycogen and probably 

 also by secondarily increased carbohydrate formation in the liver (Eppinger, 

 Falta, and Rudinger, L. Pollak). It increases the protein decomposition 

 during hunger. At the same time the respiratory quotient is temporarily 

 increased (Bernstein and Falta) . In large doses it produces in dogs increased 

 elimination of uric acid and allantoin. Often it leads to increase of tem- 

 perature. Further it brings about a neutrophilic hyperleucocytosis, during 

 which the eosinophiles vanish from the circulating blood. The simultaneous 

 increase of the mononuclear cells is a by-action, as this remains absent 

 after the administration of atropine. Finally adrenalin produces hyper- 

 globulia (Bertelli, Falta, and Schweeger), chiefly through transudation of 

 plasma. 



Apart from the accessory actions mentioned, adrenalin acts only on the 

 purely sympathetic nerve-endings, and indeed on the so-called musculo- 

 neural junction (Langley, Elliott). It is therefore a purely sympathetic 

 hormone. The giving-off of adrenalin to the blood of the vena cava is con- 

 tinuous. The blood of the suprarenal vein should contain about one-half 

 part per million of adrenalin per cc. (Ehrmann). Biedl estimates that in 

 twenty-four hours about 4.3 mg. are given off to the blood. This amount 



