THE SYMPATHETIC SYSTEM 143 



2. By subcutaneous or intramuscular injection. From 

 1/2 to 2 ccs. of a solution of 1 to 1000 can be given daily in 

 fractional doses. Subcutaneous doses have two incon- 

 veniences. They sometimes cause severe pain and they will 

 act too rapidly. For this reason medication in this manner 

 must be kept for special cases to avoid serious symptoms. 



There is, however, an excellent method of administering 

 suprarenalin subcutaneously, and that is, as advocated by 

 Josue, a dilute solution of suprarenalin. It is usually 

 prepared by adding to 250 to 500 cc. of normal saline, 1 

 milligram of suprarenalin and 1 centigram of novocain to 

 prevent pain. 



3 . By rectal administration by means of the Murphy drip . 



METHODS OF ADMINISTRATION OF THE TOTAL EXTRACTS. 



The total adrenal extract can be administered by mouth 

 in doses of from 0.30 to 0.60 centigrams daily. The 

 maximum dose should rarely be over 0.90 centigrams. It 

 is best to divide the doses into three administrations daily. 



The total extract can be administered in doses of 0.1 

 daily hypodermically. The subcutaneous administra- 

 tion is sometimes more active than the oral therapy. For 

 cases of slow adrenal insufficiency one of these methods 

 can be kept up for a month or two, by series of ten days 

 of treatment, interrupted by rest periods of from 5 to 

 10 days. 



n. ADDISON'S DISEASE. 



The disease described by Addison is characterized by 

 progressive asthenia, anemia and a pigmentation of 

 the skin. 



In his first report in 1855, Addison believed that this 

 disease was due to a tuberculosis of the adrenals. Three 

 years later he brought out the fact that there was a 

 co-existence of tuberculous lesions of the adrenals and of 



