SIGNIFICANCE OF THE SUPRARENAL GLANDS 157 



Gley and Quinquaud,(&) (c) (d) (e) in a series of papers, have shown 

 conclusively that epinephrin does not play the role attributed to it in main- 

 taining the tonus of the sympathetic. In support of their attitude of skep- 

 ticism they have shown: (a) that excitation of the peripheral end of a 

 splanchnic nerve produces its habitual effect on the arterial pressure after 

 double epinephrectomy or after ligation of the two lumbo-adrenal veins ; 

 (b) that reflex excitation of the splanchnics after these operations has the 

 usual effect upon the circulation; (c) that the excitability of the cardio- 

 accelerator and cardio-inhibitory nerves remains the same; (d) that the 

 result of excitation of the vasomotor centers by asphyxia is identical before 

 and after these operations. 



There is no good evidence that epinephrin from the suprarenals regu- 

 lates diuresis, although it has been shown that some anastomosis may exist 

 between the suprarenal circulation and the veins of the capsule of the 

 kidney. This was described by Tuffier and Lejars in the human subject, 

 where, of course, the anatomical relations of the suprarenal and kidney are 

 closer than in lower animals. According to Cow (1914) epinephrin may, 

 under certain conditions, pass from the suprarenals by this route, a conclu- 

 sion which finds support in certain observations of Stewart and Rogoff. 

 Experiments by Cannon and Nice and by Gruber(fr) have been interpreted 

 as showing that the threshold stimulus of fatigued muscles can be lowered 

 by the action of such amounts of epinephrin as are given off from the supra- 

 renals in response to stimulation of the splanchnic nerves. As has been 

 pointed out by Gruber, however, the improvement in the fatigued muscles 

 is due, in part at any rate, to the improved blood flow associated with the 

 increased blood-pressure, although he is emphatic in asserting that in- 

 creased blood flow is not the sole factor. No difference has been observed 

 in the resistance to fatigue of decapsulated and normal rats (Boinet) (b) or 

 of cats deprived of the greater part (as much as 5/6 or 7/8) of the supra- 

 renal tissue and normal cats (Stewart and Rogoff (y)). 



Epinephrin and Blood Sugar Content. In no part of the subject has 

 the lack of attention to the quantitative relations of the epinephrin output 

 led to greater errors than in the numerous investigations which have sought 

 to connect the suprarenal medulla with the regulation of the carbohydrate 

 metabolism and especially of the content of dextrose in the blood. 

 The idea that increased epinephrin output might play a part in increasing 

 the blood sugar content and, therefore, in causing glycosuria, was originated 

 by iBlum(&) who suggested that the piqure glycosuria, discovered by 

 Claude- Bernard in 1855, might be of the same nature as the glycosuria 

 caused by injection of suprarenal extract. The same question has been 

 raised in regard to other experimental glycosurias (and hyperglycemias), 

 e.g., those caused by anesthetics, by asphyxia, by emotional excitement, etc. 

 A very large number of papers have been published maintaining the indis- 

 pensability of the suprarenals for the production of these conditions and 



