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Scientific Proceedings (132) 



adrenalin subcutaneously showed a distinctly antagonistic rela- 

 tionship in the control cases. In one case in which adrenalin 

 alone gave a marked rise of R. Q., practically the same reaction 

 to adrenalin resulted when it was preceded by insulin. In an- 

 other case in which there was relatively little response to adren- 

 alin but more to insulin, the quotients followed the general di- 

 rection obtained when insulin alone was administered and there 

 was a fall of R. O. on receiving the adrenalin after insulin. The 

 calorigenetic action of adrenalin following insulin was always 

 less than that of the former when given alone. The curves of 

 heat production after the combined insulin and adrenalin injec- 

 tions lay between the low one produced by insulin alone and the 

 higher one by adrenalin alone, and was closer to the one toward 

 which the subject reacted most when receiving the drugs sepa- 

 rately. Adrenalin brought out distinct elevations of blood- 

 sugar but the rise was never as high when given after insulin as 

 when given by itself. The pulse rate and blood pressure curves 

 gave the same general picture with the combination as with 

 adrenaline alone but the extent of circulatory changes was also 

 considerably less. 



The effect of adrenalin following insulin in diabetics appeared 

 to depend upon the individual sensitiveness to the drugs and also 

 upon the condition of the patient, — e. g., severity of the sick- 

 ness, presumable glygogen stores, etc. The R. Q.'s were in 

 agreement with blood-sugar changes. With two patients previous- 

 ly injected with insulin the quotient rose promptly after adrena- 

 lin ; in two cases it fell. The heat production in this group paral- 

 leled the curve of R. Q. In two cases adrenalin after insulin made 

 the blood-sugar rise but in two cases the blood-sugar kept on 

 falling. The two cases in which adrenalin failed to raise the 

 blood-sugar showed relatively little coincident circulatory re- 

 sponse to that drug and those patients had also previously proved 

 to be relatively insensitive to adrenalin when given alone. 



