128 JOHN T. HALSEY 



due not to a direct action on the liver cells, but to stimulation of their sym- 

 pathetic nerve supply. The lessened oxidation has been attributed to an 

 inhibition of the internal secretion of the pancreas, but for this hypothesis 

 experimental proof is lacking. The study of this suprarenal diabetes 

 led to the elaboration by Falta and others of the Vienna school of an 

 ingenious theory assigning to the suprarenals an important role in diabetes 

 mellitus. According to this hypothesis, the suprarenal exerts an in- 

 hibitory influence on the production of the internal secretion of the pan- 

 creas. However, although it has been shown that epinephrin inhibits the 

 external secretion of this gland, proof is lacking that any similar effect is 

 exerted on its internal secretion. 



Metabolism. The effect of epinephrin administration, on nitrogenous 

 metabolism has been the subject of considerable investigation, but there 

 is much discrepancy in the reported results. While a number of investi- 

 gators report that proteid combustion is increased after its administration 

 (orally or hypodermically), others report no effects on the nitrogen bal- 

 ance, or at times even a nitrogen retention. Tompkins, Sturgis and Wearn 

 report that administered hypodermically epinephrin regularly increases 

 the basal metabolism. 



In view of the frequent use of suprarenal preparations in various 

 types of bone disease, and of Sergent's (a) belief that they favor recalcifi- 

 cation in tuberculosis, their effect on calcium metabolism possesses a cer- 

 tain interest. Quest, found that in dogs epinephrin caused a decrease in 

 the calcium excreted by the kidney, but a still greater increase in the 

 amount excreted in the feces, so that the total excretion was increased. 



Temperature. The temperature is but slightly affected, sometimes 

 falling, sometimes rising. In man a slight rise (maximum 0.4 C.) occurs 

 more frequently than a fall (Bauer, 1912). 



Non- Vegetative Nervous System. The very striking peripherally in- 

 duced effects of epinephrin make it very difficult to determine what, if 

 any, direct effects it produces on the central nervous system. Dixon 

 found that locally applied to the frog's cord, it caused greatly exaggerated 

 n-ilcx response, which he attributed to action on. the motor cells in the 

 anterior horn. Very large amounts cause motor paralysis, and there are 

 certain observations indicating that a central analgesic action may be 

 exerted by intraspinal injection, or by injection into the carotid (Weber). 

 In spite of such laboratory findings, however, it appears in the highest 

 degree improbable that the doses used clinically produce any important 

 (flWts on the central nervous system. Epinephrin exerts no action on 

 either sensory or motor nerves in the periphery. 



Absorption and Fat in the Body. Epinephrin is not absorbed 

 through the unbroken skin. Applied to mucous membranes or adminis- 

 tered by mouth, it is ordinarily absorbed very slowly and incompletely, 

 if at all. However, by many it is claimed that it is absorbed rapidly 



