THE SUPRARENAL SYSTEM 217 



glycogen as a result of this increase in albumin-metabolism. 

 Pollak is not inclined to explain the large quantities of glycogen 

 which he found, solely by the theory of an increased metabolism of 

 albumin ; he is disposed to leave the question open for the present. 



In answer to the question as to why the intravenous injection 

 of adrenalin is not invariably followed by glycosuria, and why 

 the repeated subcutaneous injection provokes signs of tolerance, 

 frequently expressed by the absence of glycosuria Pollak dis- 

 covered that, though the intravenous injection of adrenalin invari- 

 ably causes hyperglycasmia, this is not sufficiently marked to 

 produce glycosuria, seeing that there is, under these conditions, 

 an invariable reduction in diuresis. Where, however, simul- 

 taneously with the adrenalin injection, measures are adopted with 

 the object of promoting diuresis, sugar is invariably present in 

 the urine. After subcutaneous injection of adrenalin, the hyper- 

 glycaemia is so pronounced that glycogen will be present in the 

 urine apart from artificial promotion of the diuresis. The repeated 

 subcutaneous injection of adrenalin produces a high degree of 

 hyperglycasmia, such as is usually observed only in cases where 

 there is no simultaneous diuresis. As, however, the glycosuria is 

 not always present, it must be assumed that, either the kidneys 

 acquire a tolerance of their large glycogen contents resulting from 

 the continued employment of adrenalin, or that they are subjected 

 to some specific influence. 



W. Straub and his pupil, H. Ritzmann, have done much to 

 further a more detailed knowledge of adrenalin glycosuria. 

 Kretschmer discovered that the remarkable absence of constancy 

 in the effect of adrenalin upon the vessels, depends upon the 

 readiness with which adrenalin undergoes oxidation, and that a 

 permanent adrenalin action upon the tone of the vessels is to be 

 obtained only by a permanent employment of the drug. Ritzmann 

 next showed that the glycosuria lasts for exactly the same length of 

 time as adrenalin is present in the blood. If adrenalin in very 

 weak solution is allowed to enter a vein and to flow continuously 

 into the blood stream, it will be found that an adrenalin solution 

 of a concentration of i :2 million, introduced at a velocity of about 

 c.cm. to the minute, does not provoke glycosuria. Sugar does 

 not appear in the urine until the velocity reaches 3 to 4 c.cm. 

 per minute. Within certain limits, there is a direct proportion 

 between the concentration of the adrenalin in the blood and the 

 amount of sugar excreted in the urine ; so that, other things being 

 equal, each velocity of a solution of given concentration provokes 

 a glycosuria which invariably yields the same amount of sugar 

 within a given space of time. The glycosuria does not make its 

 appearance immediately, but is preceded by a prolonged latent 

 stage, which is probably accounted for by the fact, that a certain 

 amount of time is required for the completion of the chemical 

 process by which the sugar is set free. There is, moreover, an 



