3 o ENDOCRINE THERAPEUTICS 



that adrenalin did not do, it was to raise blood- 

 pressure." Probably these tests were made on 

 healthy folk, but in the very low pressures of 

 acute fevers, such as diphtheria and pneumonia, 

 there is nothing in my experience so certain to 

 raise pressure as suprarenal, but it only lifts it to 

 the normal, and doing this it is the safest and the 

 most efficient tonic we possess. Strychnine acts 

 chiefly by increasing the output of adrenalin. 

 In these acute diseases, however, the gland has 

 almost struck work, for the adrenalin contents of 

 the gland after death have been proved to be 

 almost nil. Surely it is wiser to supply freely the 

 deficiency from without than to attempt to flog 

 a dying gland into activity. In such cases the 

 sphygmomanometer should be our constant guide. 

 It is quite safe to give a 5 grain tablet of the fresh 

 gland (such as is always on the market) every 

 4 hours or oftener, till the pressure amounts to 

 130 mm. or to 140 mm., the former in children and 

 the latter in adults. Death in these diseases is 

 often said to be due to heart failure, but the chief 

 cause of that failure is adrenalin starvation. 



That the heart muscle is strongly stimulated by 

 adrenalin is shown by this experiment : a frog's 

 heart, removed from the body, that has just 

 ceased to beat will at once start again if Jplaced 



