As previously stated, this work is in tended to portray the prevailing views of the profession, and not our own doc trines, pending confirmation of the let ter. The interpretation of Auld (Brit. Med. Jour., June 3, 1S99) presents, in the aggregate, the conclusions to which other investigators have been led:— "The available evidence goes to show that the suprarenal acts by destroying deleterious substances, and also by fur nishing a material to the blood. As the work seems to be done by the medulla, there is considerable ground for regard ing the vasocoustricting substance as evi dence of the former function." Physiological Action.—There is good ground for the belief, however, especially since the experimental investigations of Brown-Sequard, Abelous, Langlois, and Dubois, that the physiological function of the suprarenal capsules is to transform or to destroy the toxic substances which are produced in the organism under the influence of muscular activity and of the nervous system. The destruction of these organs is thought to be capable of causing in the organism an accumulation of toxic agents which is the principal cause of the sensation of extreme fatigue and of the profound and generalized asthenia experienced by patients who suffer from Addison's disease.
The evidence that the suprarenal cap sules contain a toxic substance of great activity, much more active than that of any other gland, seems quite con clusive.
Extracts made from the suprarenal glands of the calf, sheep, guinea-pig, cat, dog, and man have a similar action. Dis eased glands from cases of Addison's disease were found by them to he inert. The active principle, whatever it is, must therefore he recognized as an ex ceedingly powerful body, if we reflect that of this 'I, grain about SO per cent. is water, and another very large pro portion must consist of the proteids, etc., of the gland-substance. Oliver and Schiffer (Jour. Phvsiol., vol. xviii, pp. 230-276).
The experiments of Dubois would tend to show that the toxic substance isolated is identical to muscle-toxin: e.g., orig inating in the muscles. Being foreign to the capsules themselves, these organs would have the destruction of the toxic products as their physiological function. Several albumoses found in the capsules which in themselves seem to possess no well-marked toxic properties would, ac cording to Dubois, possess the properties presented by the organ when used as a remedy.
Suprarenal extract is much more toxic than the extracts of ether glands. In travenous injections of 30 centigrammes to I gramme of a 25-per-cent. solution in glycerin and water killed a rabbit of 1500 grammes in a few moments, while 6 to 12 grammes of other extracts did not produce death. The injection was followed at once by paraplegia, later by convulsions and opisthotonos. If only
injected under the skin the animals sur vived several days, while after death nothing but parenchymatous nephritis could be found. Immediately after each injection a very marked increase in the blood-pressure was observed. Gluzinsky (Wiener klin. Woch., '95).
Toxic substance separated from the gland, soluble in alcohol, which caused death in rabbits from respiratory failure. It had no paralytic action. but seemed to act on the central nervous system. Gourfein (Bull. de l'Acad. de MCA., p. 331, '95).
If suprarenal bodies of the calf, sheep, or dog were injected, even in very small quantities, into a vein in a dog or a rabbit the following pronounced physi ological effects were produced: 1. Ex treme contraction of the arteries, which was shown to be of peripheral origin. 2. A remarkable and rapid rise of the arte rial blood-pressure, which took place in spite of powerful cardiac inhibition, and became further augmented when the vagi were cut. 3. Central vagus stimulation so pronounced that the auricles came to a complete stand-still for a time, al the ventricles continued to con tract, but with a slow, independent rhythm. 4. Great acceleration and aug mentation of the contraction of the auricles and ventricles after section of the vagi,—the auricular augmentation being especially marked. 5. Respiration only slightly affected, becoming shal lower. G. Oliver and E. A. Schiffer (Jour. of Physiology, Apr., '95).
The active principles of adrenal divided into two classes: (1) several albumoses which are precipitated with alcohol and redissolved in water and which whea isolated have no well-marked toxic effect, but which alone possess the property of destroying toxins, especially those origi nating in muscular tissues; (2) a class composed of bodies which resemble in their constitution and reactions the alka loids, having a marked degree of toxic effect resembling muscle-toxins. Dubois (Arch. de Phys. Norm. et Path., vol. viii. p. 412, '96).
The active substance contained in the medullary portion of the capsule and the activity of the extract shown to run parallel with the distinctness of certain color-reactions (e.g., a green with ferric chloride), which are due to a substance which has not yet been isolated in a pure state. Fraenkel (Wiener med. Bi., '96).
Experiments showing that after sec tion of the medulla and extirpation of the spinal cord, the injection of suprar enal extract is capable of prolonging life of the animal, which would otherwise quickly succumb. Strickler. in 1S77. proved that extirpation of both the cer vical and thoracic parts of the spinal cord mused instantaneous stoppage of the heart's action. liiedl (Lancet, Mar. 21, '96).