. 74 FIELDING H. GARRISON 



effects similar to those produced by electrical stimulation of tlie sympa- 

 thetic, viz., dilatation of the pupil, dry mouth from diminished salivary 

 secretion, rapid heart action, glycosuria, and increased secretion and mo- 

 tility of the stomach and intestines. Hence, adrenalin, and drugs, like 

 ergotoxin, which resemble it in action, are variously termed sympathico- 

 tropic, sympathicotonic, or sympathicomimetic. On the other hand, cer- 

 tain drugs, such as pilocarpin, muscarin, physostigmin, cholin, and digi- 

 talis, which stimulate the autonomic fibers of the vagus, producing effects 

 diametrically opposite (contraction of the pupils, profuse salivation, slow 

 heart action, pollakiuria, etc.), are termed vagotropic, vagotonic, or vago- 

 mimetic, because their action simulates the vagal autonomic. Thus, the 

 Viennese clinicians postulate two opposing diathetic conditions, sympa- 

 thicotonus and vagotonus, the symptomatology of which can be thrown 

 into relief by certain pharmacodynamic tests, which have been likened by 

 Januschke to "tuning keys, by means of which we can operate upon the 

 complicated stringed instruments of the body, and voluntarily make one 

 string tighter to increase its vibration or another looser to dampen its 

 function" (Barker). These opposing conditions were included by S. 

 Soils Cohen under a single syndrome, vasomotor ataxia (1892). To com- 

 plete the analogy of their tripod of ductless gland correlations, Eppinger 

 and Hess assume that the pancreas, controlled by the vagal autonomies, 

 secretes a hormone "autonomin," which is supposed to antagonize adrena- 

 lin, the hormone of the sympathetic system proper. So far, this is a very 

 cogent and fascinating theory, but, as often happens, it does not work out 

 according to specifications in all cases, and is strongly opposed by Gley. 8 

 The symptomatology in vagotonic and sympathicotonic patients, too com- 

 plex to be considered here, is extremely variable and the reaction to drugs 

 sometimes unreliable. Thus, Eppinger and Hess themselves found that 

 pilocarpin and epinephrin sometimes produce strong reactions in the same 

 patient, The interest of their theory for present purposes lies in its capac- 

 ity for elucidating the action of the ductless glands and internal secre- 

 tion, for behind the ductless glands and the hormones themselves there 

 must be some control lino- mechanism. It is assumed that when the vege- 

 tative and vagal autonomies are overexcited (sympathicotonia, vagotonia), 

 these act upon the viscera and the ductless glands, the hormones or internal 

 secretions of which in turn react with redoubled force via the blood chan- 

 nels upon the autonomic nerve centers, vegetative and vagal. The theory 

 s that the hormones of the viscera and the internal secretions of the duct- 

 less ahmds appear to regulate the tonus of the nervous system, while the 

 autonomic nerve fihers themselves regulate the action of the ductless glands, 

 the viscera, blood vessels, and all organs containing involuntary muscle. 

 'I ho importance of the subject in relation to clinical medicine has been well 



emphasized by Professor L. F. Barker (//,) (1913) : 



"For a recent critique on this topic see Vincent (6), 1917. 



