2 



Scientific Proceedings (25). 



If it had not been for a further observation I should not have 

 ventured to bring this to your attention, but during June, 1907, I 

 had occasion again to demonstrate the physical signs and physio- 

 logical records in cats under heavy doses of adrenalin. To provide 

 a more complete picture of the cardiac and pulmonary changes I 

 used a cat under ether with the anterior chest wall removed and 

 artificial respiration established. This cat, like another on an 

 adjoining table, under normal respiration, showed the high blood 

 pressure, and presently the moisture accumulating in the trachea. 

 The heart in the cat with the chest opened presented the dilated 

 right side of the heart, its deep venous hue and regurgitant murmur 

 as usual, but presently these signs improved and the lungs from 

 appearing deeply congested and sodden, became clear and pink, 

 the serous exudate no longer obstructed the trachea, and the 

 heart resumed its normal size, color, and rate. In the meantime 

 the condition in the other cat was one of progressing edema. 



In spite of the fact that cats, as well as rabbits, vary in their 

 susceptibility to commercial adrenalin solutions, the changes in 

 the picture above described, appeared too definite and too prompt 

 to be due to any individual recuperative power or insusceptibility. 

 I believe the change in the cat with the chest opened was due to 

 the conditions of artificial respiration. Air was being forced into 

 the lungs under pressure to distend them against their inherent 

 elasticity and atmospheric pressure. Thus the pulmonary vessels 

 may be considered as being subject to distinct positive pressure 

 from without, recurring rhythmically with artificial respiration. 

 It seems to me conceivable that this may have assisted the passage 

 of blood from the right to the left heart, and in this way supple- 

 mented the right ventricle. 



The effect of adrenalin in causing edema is not necessarily to 

 be concluded a sufficient reason for avoiding its use therapeutic- 

 ally for relief from edema, since edema which has its origin in 

 vascular relaxation, the vaso-paresis which occurs in the toxemia 

 of pneumonia and diphtheria infections, as shown by Romburg and 

 Passler, is an entirely different clinical picture from the edema 

 resulting from contracted arteries and failing heart, such as occurs 

 in nephritics and severe arteriosclerotics. 



In one instance adrenalin will improve the circulation by sub- 



