THE ADRENAL BODIES 207 



bladder, and uterus, and even the bleeding of post-partum 

 haemorrhages, may thereby be effectually controlled." The 

 explanation offered is that injured vessels are more sus- 

 ceptible to the extract and react to a slight excess of it in 

 the blood more readily than do normal vessels. But Miller 

 considers that as regards vessels not accessible to local applica- 

 tions the constrictor action of adrenin is more than counter- 

 balanced by the sudden increase of general blood-pressure. 

 He states that in rabbits he has observed that in a wound the 

 vessels that have stopped oozing often start bleeding after an 

 intravenous in j ection of adrenalin . In pulmonary haemorrhage , 

 he thinks, there is the additional danger of possible absence of 

 vasoconstriction, and therefore the bleeding might increase by 

 having a condition of dilated vessels with increased pressure. 

 Schafer replies to this that administration by the mouth does 

 not perceptibly raise the systemic blood-pressure, and that, 

 nevertheless, there is considerable clinical evidence that inter- 

 nal haemorrhages, when not too profuse nor coming from large 

 vessels, may be brought under control by oral administration, 

 especially if, as he suggests, the extract has a greater effect 

 upon injured vessels. 



The question just discussed, naturally, is of great import in 

 relation to the treatment of haemoptysis. Batty Shaw inclines 

 to the view that hypodermic or oral administration of adrenin 

 can have little effect upon bleeding occurring from destructive 

 tuberculous disease of the lungs, and he attaches comparatively 

 little importance to the clinical reports which so far have been 

 published, and in which it is impossible to say that the good 

 results were not due to other factors. 



Quite recently Wiggers has investigated the value of adrena- 

 lin in inaccessible internal haemorrhages. He concludes that 

 large doses of the drug (0-05 to 0-1 milligramme) cause a short 

 preliminary increase of haemorrhage followed quickly by a 

 decrease or cessation of bleeding. On account of the great 

 preliminary loss of blood, they are always contra-indicated. 

 Small doses (0-01 to 0-025 milligramme) cause little or no 

 preliminary increase, but shorten the course of haemorrhage. 

 As they save the red blood cells in every way, they are thera- 

 peutically desirable. Continuous intravenous injection of 

 weak solutions maintains a slight elevation of pressure, and 

 haemorrhage is simultaneously checked. This can also be 



