36 ENDOCRINE GLANDS 



exaggerated after the injection of suprarenalin or pituitrin. 

 In thyroid insufficiency the glycosuria and the drop in 

 systolic pressure -are normal, but the acceleration of the 

 pulse occurs instead of slowing. In patients with Addi- 

 son's disease there will be no glycosuria and the systolic 

 pressure will rise instead of going down. 



Without doubt it is too early to deduct from these tests, 

 definite conclusions. They are liable to occur in transi- 

 tory endocrine disturbances after infectious diseases, for 

 instance, without this being an indication of any perma- 

 nent lesion of the gland. Nevertheless, they are liable 

 to give us some idea of the endocrine equilibrium and when 

 we understand these reactions better we probably will be 

 able to refer to them clinically to help us in diagnosis. 



These tests, furthermore, bring out the intervention 

 of the sympathetic. It is the stimulation of this system 

 which after the injection of pituitrin inhibits the fixation 

 of glucose by the liver, its stimulation seems to play a part 

 in certain of the effects of suprarenalin. Lately, the in- 

 jection of suprarenalin has been used as a method of show- 

 ing up excitability of the sympathetic. Dr. Harvier has 

 gone over in detail the various plans of this subject, partic- 

 ularly those of Eppinger and Hess on the injection of 

 suprarenalin on one side and atropin and pilocarpin on the 

 other. The injection of suprarenalin is inactive in some, 

 in others it causes an increase in the blood pressure; tachy- 

 cardia, polyuria, glycosuria with or without the previous 

 injection of glucose, dilatation of the pupil, etc. It stimu- 

 lates the sympathetic and such individuals are called 

 sympathicotonic. Pilocarpin inversely, in predisposed 

 individuals, causes a marked tachycardia, sweating, 

 salivation, nausea, vomiting, spasms of the intestines, 

 colic and diarrhea. In others, it is without effect. It 

 stimulates the vagus nerve in the first type of case, which 



