Volume 1

The Internal secretions and the principles of medicine / by Charles E. de M. Sajous.

  • Sajous, Charles E. de M. (Charles Eucharist de Medicis), 1852-1929.
Date:
1903-1907
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: The Internal secretions and the principles of medicine / by Charles E. de M. Sajous. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

    95/872 (page 61)
    vegetable diuretics, buehu and uva ursi, undoubtedly do so, and it seems probable that it is only with toxic doses of their active principles—hydroehinone in the case of uva ursi, for instance—that the stage of suprarenal insufficiency can at all be reached. Digitalis gives rise to very marked symptoms of suprarenal overactivity, followed, when excessive doses are ad- ministered, by the typical signs of insufficiency.^^* Huchard aptly ascribes Petresco's remarkable results in pneumonia, in this connection, to the fact that the digitalis-leaves employed by him were rich in alkaline salts. The diuretic effect and the continued alkalinity of the plasma thus insured must cer- tainly have done much to enable him to obtain the remarkably low death-rate reported: i.e., 2.06 per cent, of 825 cases treated. The bearing of a reduced sodium-chloride ratio upon the prognosis of this disease is well known. Among general remedies, the coal-tar products—anti- pyrin, acetanilid, sulphonal, etc.—may be classed with those which give rise to a short stage of excitement, attended some- times, in the case of acetanilid, with copious urination. Here, again, all the signs observed after removal of both adrenals occur, and when anuria is absent methsemoglobinuria or hsema- toporphyrinuria sometimes appears. Yet the bladder must always be taken into account in such conditions. Wood says, for example, that this organ is completely paralyzed in ad- vanced atropine poisoning. While forcible expulsion of urine occurs in the primary stage,—that of suprarenal activity,—the flow steadily decreases and finally ceases. It rises and falls with the arterial pressure, observed Meuriot^^: a strong hint that the adrenal functions are involved. All these facts seem to us to show that what are noiv con- sidered as the cardinal symptoms of poisoning are, in reality, manifestations of overactivity or of insufficiency of the adrenals, and that the functions of these organs may be stimulated, inhibited, or arrested in two ways:— 1. By a direct action of the toxic agent upon their cellular ° This gives us a clue to the meaning of the supposed cumulative property of digitalis. Continued stimulation finally overtaxes the adrenals. Meuriot: Quoted by Wood, loc. cit., p. 174.