ADDISON S DISEASE 349 



8.3 kg. dog, Mar. 5, sugar in blood 0.1008 per cent. 



On March 8, the dog received daily 25 cc. of a i per cent, solution of adrenalin 

 through the stomach tube. 



From March 9 to 16, inclusive, 25 cc. adrenalin twice. 



Mar. 1 6, sugar in blood, 0.1552 per cent. 



From Mar. 19 to 30, inclusive, 25 cm. adrenalin twice. 



From Mar. 13 to 17, a trace of sugar was demonstrable in urine, later the urine was 

 always sugar-free, but contained traces of protein. 



Subcutaneous injection of adrenalin is not advisable for any length of 

 time. Boinet saw manifestations of collapse. Also after the injection of 

 the glycerine extract of the whole suprarenal there occurred in Boinet's case, 

 after a time, conditions of excitement, tremor, and insomnia. Perhaps, 

 however, a slight result is to be obtained by the peroral administration of 

 tablets made from the whole gland. According to Magnus-Levy, the pigmen- 

 tations have become lighter in color after the administration of these 

 tablets, under certain circumstances. 



The beautiful investigations of v. Haberer and Stoerck as to the healing-in 

 of pedunculated suprarenal glands [transplanted] into the kidney scarcely 

 give hopes for a practical application, as apart from the necessary peduncula- 

 tion, probably only autotransplantations of the suprarenals are possible. 



Only the symptomatological treatment remains. Grawitz recommends 

 washing the stomach with sodium chloride solution, predomination of vege- 

 tative diet, avoidance of alcohol, and hydrochloric acid medication. Grawitz 

 saw a case that presented all the symptoms of Addison's disease which 

 benefited under this treatment. Also the pigmentations of the skin disap- 

 peared. The case was observed for a period of three years after this success- 

 ful result. Very important in Addison's disease is the avoidance of every 

 severe exertion. Boinet reports seven cases of sudden death in Addison's 

 disease, immediately after a marked fatigue. 



Proceeding from the observation that dogs after the extirpation of their 

 suprarenals, lose all their glycogen except traces, O. Forges combated the 

 adynamia in several cases of Addison's disease by the administration of 

 large amounts of carbohydrates (especially of levulose) with good results. 

 Also Gautrelet reports favorable results. 



Here might also be mentioned the favorable results of adrenalin in other 

 diseases. Very widespread is the employment of adrenalin in the stilling of 

 hemorrhage. Proceeding from the observation that animals bear enormous 

 amounts of adrenalin, Turin and / in ulcus ventriculi increased administra- 

 tion of adrenalin per os up to 7 mg., thrice daily, and up to the present have 

 seen good results. Many authors report the excellent action of adrenalin in 

 condition of collapse (John and others), especially in the infectious diseases 

 (for example, Heubner, in diphtheria). According to our observations 

 adrenalin given subcutaneously, too, in man increases the blood-pressure, 



