SIGNIFICANCE OF THE SUPRARENAL GLANDS 165 



innervated gland as compared with its denervated fellow is caused by the 

 action (for some hours) of narcotics, like morphin, ether, chloroform, 

 urethane; of l^tetrahydronaphthylamin, and other drugs; and of certain 

 bacterial toxins. 



The diminution in the epinephrin store produced by morphin in the 

 cat has nothing to do with the apparent psychical excitation expressed by 

 the incessant restless movements, dilated pupils and staring eyeballs 

 associated with the action of the drug in this animal. For a precisely 

 similar depletion is seen in the still innervated gland in the dog, in which 

 the narcotic action of morphin is typically displayed. And the intense 

 excitement produced by the natural antipathy of dog and cat causes no 

 depletion of the epinephrin store of the innervated as compared with the 

 denervated gland even when the excitement is continued for several hours 

 (Stewart and Rogoff(c), 1916). 



Some writers seem to assume that any condition which causes de- 

 pletion of the epinephrin store produces this effect by augmenting the rate 

 of epinephrin output. This is erroneous. The store represents the balance 

 between epinephrin formed and epinephrin liberated, and a diminution 

 in the store may be due either to diminished upbuilding or to increased 

 discharge. In the case of ether and some other anesthetics, there is 

 no evidence of any stimulation of the output, and it is probable that the 

 depletion of the store of epinephrin in the innervated gland is due, mainly 

 at any rate, to the steady liberation of epinephrin at approximately the 

 ordinary rate while the new formation of epinephrin is interfered with. 

 If no epinephrin at all were formed under the influence of these drugs, its 

 continued liberation for 5 or 6 hours, without augmentation in the rate of 

 output, would reduce the store by approximately 50 per cent, and the 

 depletion actually observed is of this order of magnitude. It is not known 

 in what way drugs like P-tetrahydronaphthylamin cause depletion of the 

 epinephrin store, whether by increasing the output or by diminishing the 

 formation of epinephrin, or possibly by a combination of both actions. 

 Morphin has been shown to increase the output in cats (to as much as 

 ten times the original rate.) But this cannot be the sole cause of the 

 diminution in the epinephrin store. For in dogs the increase in output 

 is trifling in comparison, or there is no definite increase. As already re- 

 marked, strychnin, which greatly augments the output, does not affect the 

 store (Stewart and Rogoff). 



Before leaving this subject it must be remarked, to prevent misappre- 

 hension, that it has been clearly demonstrated by Elliott(c) (1912) that 

 epinephrin can be formed and stored in the suprarenal after as complete 

 denervation as is practicable. Of course, some nerve fibers running in on 

 the blood vessels, etc., may escape. The denervated gland, as already 

 stated, regains its normal load, somewhat depleted by the anesthesia and 

 operation, in the course of a day or two, and maintains it thereafter. 



