ORGANOTHERAPY AND HORMONOTHERAPY 127 



Eye. In addition to producing local vasoconstriction, epinephrin, by 

 stimulation of the sympathetic nerve endings, causes retraction of the eye- 

 lids and exophthalmos ; and, if it penetrates sufficiently into the inner 

 eye, mydriasis results from stimulation .of the nerve endings of the 

 dilator pupillse. Loewi found that in pancreas diabetes the repeated in- 

 stillation of epinephrin solution (1-1000) into the eye caused well marked 

 mydriasis, although in normal human beings this is not the case. The 

 same effect is produced in cases of hyperthyroidism and other states of 

 abnormal excitement of the sympathetic nervous system. With further 

 observation, the diagnostic significance of this eye test has been found 

 to be of little or no value. 



Voluntary Muscle. The contraction of normal muscle is not affected, 

 but its relaxation is greatly slowed as by veratrin. In fatigued muscle 

 (frog's gastrocnemius), epinephrin temporarily restores the power of 

 contraction. Later investigations threw doubt on these views, but the 

 most recent one by Guglielmetti fully confirms them. In Addison's dis- 

 ease, Dupaigne and Langlois demonstrated ergographically that the pro- 

 longed administration of suprarenal substance increased muscular power, 

 and Trerotoli obtained similar effects from hypodermic administration of 

 epinephrin. This finding appears significant in view of the reported 

 favorable influence exerted by suprarenal medication on the asthenia of 

 Addison's disease. Mention should be made also of the fibrillary contrac- 

 tion of voluntary muscles in the shivering which often accompanies the 

 systemic action of epinephrin, although it is quite possible that this 

 shivering is an indirect result of cutaneous vasoconstriction. 



Secretions. The tears, saliva,, and bile are increased by epinephrin. 

 In the case of the last, it would appear that it is not so much an increase 

 of secretion which is caused, as it is an increased excretion resulting from 

 contraction of the large bile ducts, and perhaps of the gall-bladder also. 

 The sweat glands are not affected, although they are supplied by nerves 

 which anatomically appear to belong to the sympathetic system, but which 

 in their pharmacodynamic reactions behave like parasympathetic nerves. 



Kidneys. The renal vessels are primarily contracted by epinephrin, 

 and later dilated. As a result, urinary secretion is first diminished, 

 later increased. A short-lived polyuria not infrequently follows its hypo- 

 dermic administration, especially when it is used in combination with 

 cocain. 



Suprarenal Glycosuria was first noted by Blum in 1901 and studied 

 intensively by Herter and others, who found that the administration of 

 epinephrin intravenously, hypodermically, or intraperitoneally is, under 

 normal conditions, regularly followed by a temporary hyperglycemia and 

 glycosuria. Theste are due to an acceleration of the transformation of 

 glycogen into glucose, and also in some degree to lessened oxidation of 

 glucose. The acceleration of the transformation of glycogen appears to be 



