ADRENALIN 449 



inhibited, and lost in poisoning, through stimulation of the splanchnics. 

 The same action is exerted on the gall bladder whose movements are 

 inhibited. The pyloric, anal and ileo-colic sphincters, on the other hand, 

 receive motor fibres from the sympathetic and are thus contracted by the 

 stimulation of the sympathetic. Action on the uterus (contraction or 

 relaxation from preponderance of inhibitory or motor fibres) varies with 

 the species of animal and whether pregnant or non-pregnant, according 

 to the particular effect of the sympathetic stimulation. The same remark 

 applies to the action of adrenalin on the urinary bladder. 



Eye. — Dilatation of the pupil, owing to sympathetic nerve stimula- 

 tion, occurs after the intravenous injection of adrenalin solution but not 

 when it is instilled into the eye. 



Toxicology. — Poisoning may be produced in animals by the intra- 

 venous and subcutaneous injection of adrenalin. In smaller poisonous 

 doses there are glycosuria, diuresis and nephritis, while fatal amounts 

 cause vomiting, restlessness, tremors, paraplegia, prostration, dyspnea 

 from edema of the lungs, respiratory failure and death. Sugar appears 

 in the urine after toxic doses owing to an abnormal increase in the split- 

 ting of liver-glycogen and its discharge as sugar into the blood. There 

 is increase in the secretion of saliva, tears, bile and esophageal and bron- 

 chial mucus. The secretions are increased by sympathetic stimulation 

 but not greatly, on account of the vascular constriction. Ill effects from 

 therapeutic use of adrenalin include 1. Local relaxation of the vessels, 

 following local use, with secondary hemorrhage. 2. Hemorrhage 

 increased, if given in cerebral or pulmonary bleeding, from lack of con- 

 striction of vessels in these organs aild generally increased blood pressure. 

 3. Pulmonary edema and left ventricle failure from general vasocon- 

 striction with weak heart. 



Summary. — Study of the evolutionary development of the suprarenals 

 shows that the secreting portion of the glands is derived from and is 

 controlled by the sympathetic system. Suprarenal secretion (adrenalin) 

 acts in the body to always and everywhere stimulate sympathetic nerve 

 endings. 



Thus it stimulates the heart (accelerator stimulation), constricts 

 blood vessels (vasoconstrictor stimulation), inhibits the action of the 

 stomach and bowels (splanchnic stimulation), dilates the pupU (sympa- 

 •thetic nerve stimulation), and contracts or relaxes the uterus according 

 as to whether the motor or inhibitory fibres predominate in the hypo- 

 gastric nerve. 



Powerful emotions, as fright or anger, lead to immediate increased 

 secretion of the adrenals in the normal animal, and the phenomena of 

 dilated pupils, erection of hair, inhibition of digestive movements and 

 increase of blood pressure, are typical of sympathetic 'stimulation. 



Adrenalin given during administration of chloroform has a very 

 unfortunate effect in leading to ventricular fibrillation and perhaps death. 

 Uses. — Earternal. — ^Adrenalin chloride is commonly sold in a 1 to 

 1000 aqueous solution in the shops. It has proved of most value when 

 combined with cocaine for subcutaneous use in operative work. One 

 part of the 1-1000 solution may be added to nine parts of normal salt 

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