THE SUPRARENAL SYSTEM 215 



Kraus and R. Hirsch, as well as those of Quest, show that there 

 is little alteration in the metabolism of nitrogen in healthy dogs 

 after the intravenous or subcutaneous injection of adrenalin. The 

 slight increase in N-metabolism is explicable by the glocosuria 

 which is coincident with it, as well as by the necrosis of the skin 

 which follows subcutaneous injection. Eppinger, Falta and 

 Rudinger found that, in starving animals, adrenalin caused a 

 marked increase in the metabolism of albumin ; feeding with fatty 

 foods still further increased the effects of adrenalin. The increased 

 excretion of nitrogen which, in starving animals, immediately 

 followed the injection of adrenalin and which was also observed 

 by Underbill and Closson, cannot in the nature of things be re- 

 ferred to necrosis of the skin. Eppinger, Falta and Rudinger 

 regard the increase in the metabolism of albumin and of fats as 

 the expression of an improved thyroid function. 



According to the investigations of Falta, Bolaffio and 

 Tedesko, adrenalin excites an increase in the metabolism of salt. 

 The amount of phosphorus excreted in the urine may be increased 

 to three times, that of potassium and sodium to four times, the 

 normal. With regard to the metabolism of purin, Falta declares 

 that the excretion of uric acid and of allantoin are both consider- 

 ably increased. 



This effect which adrenalin has in accelerating metabolism is 

 regarded by authors of the Viennese school as an expression of the 

 condition of increased excitability which this substance produces 

 in the sympathetic system. 



That aspect of metabolism which, it is conclusively proved, 

 lies within the province of the sympathetic system, is the 

 metabolism of the carbohydrates. The influence which adrenalin 

 exercises upon these conditions has, therefore, a special interest. 



When Blum, in 1901, made the important discovery that the 

 experimental subcutaneous or intravenous injection of suprarenal 

 extract produces glycosuria, which follows with equal certainty in 

 both starving animals and those deprived of the carbohydrates, 

 there was a general inclination to regard this result as the mani- 

 festation of a toxic activity on the part of suprarenal extract. 

 It formed the subject of keen and very minute investigations, and 

 these have revealed the fact that the glycosuria which follows the 

 exhibition of adrenalin, is the expression of a physiological action 

 on the part of this remarkable substance. 



Blum's discovery was tested and confirmed in many direc- 

 tions. It soon became evident that the glycosuria makes its 

 appearance after the exhibition both of the extract of the supra- 

 renal and of adrenalin, its active principle. For this reason, it 

 was very generally believed that glycosuria is one of the physio- 

 logical effects of adrenalin. The sole author who opposed this 

 view was Landau, who ascribed the glycosuria to a substance 

 derived from the suprarenal cortex. 



