180 GLANDS IN HEALTH AND DISEASE 



Neither have Drs. Stewart and Kogoff less sharp 

 criticism to offer with regard to the alleged con- 

 nection of adrenaline with the condition known as 

 "shock," a subject we have discussed in the last few 

 pages. "A large though quite undeserved place has 

 been occupied in clinical literature of shock and 

 allied conditions by adrenal insufficiency, or one 

 or other of its aliases. There is no evidence that 

 any notable change occurs in the adrenaline output 

 in either direction." The experimental methods of 

 producing shock in dogs and cats by exposing and 

 manipulating the intestines, by partial occlusion of 

 the inferior vena cava, by hemorrhage and by "pep- 

 tone" injection led to a permanent lowering of 

 blood pressure ; but the rate of output of adrenaline 

 after the blood pressure had been permanently 

 lowered was found to be the same as before the 

 lowering of the blood pressure, "within the limits 

 of error of the methods used for assaying the 

 adrenaline." 



Professor Stewart's caustic pen hits at the 

 "clinical endocrinologist" even more than at the 

 experimental physiologist. He writes : "In reading 

 the papers by 'clinical endocrinologists/ especially 

 the French and Italians, the physiologist can 

 scarcely escape the feeling that here he has broken 

 through into an uncanny fourth dimension of medi- 

 cine, where the familiar canons and methods of 

 scientific criticism are become foolishness, where 



