152 G. K STEWART 



in chronic* nephritis. He reports that in a case of Graves' disease he 

 found a concentration of 1 :400,000 in the venous blood, which, according 

 to the best available data, would imply a concentration in the suprarenal 

 vein blood of probably at least 1:1,000 or 1:2,000. This is entirely out 

 of the question. He also asserts that he was able to detect epinephrin 

 (1 :20,000,000 or more) in all specimens of normal human blood. 



Cannon and de la Paz stated that in cats frightened -by a barking dog 

 so much epinephrin was poured out that the femoral vein blood gave a dis- 

 tinct epinephrin reaction with the intestinal strip. Batelli(c?) concluded 

 that normal dog's serum contained 1:10,000,000 to 1:20,000,000 "adren- 

 alin," an absolutely impossible result. Schur and Wiesel's(a, c) observa- 

 tions on the mydria'tic action on the isolated frog's eye of serum and urine 

 in various diseases are also entirely valueless. They were justly criticized 

 by Waterman (a), Stewart(c) (1912), combining the rabbit intestine seg- 

 ment method and the rabbit uterus method, was unable to find any evidence 

 of epinephrin in blood withdrawn by puncture of a vein from patients suf- 

 fering from various diseases, including Graves' disease and conditions 

 showing arterial hypertonus. Janeway and Park, using Meyer's artery 

 strip method (both coronary artery and peripheral artery, which react in 

 the opposite way to epinephrin), obtained a negative result in normal 

 human citrated blood, and also in blood from a case of chronic nephritis 

 with high blood-pressure. 



Small as the concentration of epinephrin may be in arterial blood, there 

 is evidence that it may exert a certain action. Gley and Quinquaud(e) in- 

 deed, stated that they were unable to obtain any reaction indicating the 

 presence of epinephrin even in the blood of the right heart, although a 

 reaction might be given by blood from the inferior cava above the adrenal 

 level. But this is simply because the test employed by them (the rise 

 of blood-pressure caused by injection of the blood into another animal), 

 although a reliable test, is not a particularly sensitive one. It has already 

 been mentioned that when the splanchnic is stimulated, various definite 

 epinephrin reactions are elicited (dilatation of the pupil and retraction 

 of the nictitating membrane of the eye, sensitized by previous removal of 

 the superior cervical ganglion), a characteristic blood-pressure curve with a 

 double peak 2 and acceleration of the heart ( Elliott (c) 1912 ; v. Anrep (a) 

 Pearlman and Vincent). Here, of course, there is an abrupt increase in 

 the rate of epinephrin output. But there is evidence that the ordinary 

 output also exerts an influence. For example, when the sensitized pupil 

 has been caused to dilate by epinephrin, it comes back more slowly to its 

 original size if the suprarenal circulation is free than if the suprarenal vein 

 blood is prevented from entering the circulation (Stewart and Rogoff(i) 

 1917). This shows that the epinephrin coming off at the ordinary rate 



-Gley and Quinquaud (g) state that the "double peak" is not seen in rabbits and 

 only in some dogs and cats. When present, it is not affected by adrenalectomy, and 

 therefore not due to epinephrin. 



