IS EPINEPHRIN INDISPENSABLE FOR THE ORGANISM?

1917 Journal of the American Medical Association  
The physiologic potency of epinephrin has given it a widespread prominence alike in physiology, pharmacology, pathology and therapy. Any one who has witnessed the intense blood pressure raising effects of almost vanishingly small quantities of suprarenal extract or of the isolated epinephrin cannot fail to be impressed by such striking manifestations on the part of a biologic product. The diversity of the responses which can be produced serves to augment still more the interest in the active
more » ... st in the active principle of the suprarenal structures. The local styptic power, so invaluable in diminishing inflammation and reducing hemorrhages; the relaxation of the muscles of the bronchioles, now familiar in the management of asthma; the profound effects on all structures innervated by the sympathetic nervous system; the production of hyperglycemia and glycosuria following administration of epinephrin, and its consequent relation to liver function\p=m-\theseare some of the familiar phenomena that have been demonstrated repeatedly or are already familiar in the routine of practice. Lately this interest in epinephrin has been height¬ ened by the widely discussed associations of the supra¬ renal bodies and certain mental states. These glands are asserted to participate in the emotions in a remarkable way. For example, during anger or fright, in some species, at any rate, something having the properties of epinephrin appears to be discharged into the blood in more than usual amounts. This is assumed to promote precisely tifose responses and pre¬ pare those conditions that favor a suitable performance on the part of the organism under the emergency that provokes the liberation of the hormone. These observations are of the greatest interest as indications of a remarkable association of the glands with the emotions. But as Mathews1 has significantly remarked, it must not be incorrectly inferred that the emotion of fright depends on the suprarenal glands, or that the manifestation of this emotion necessarily so depends. The fact is probably quite otherwise. 1. Mathews, A. P.: Physiological Chemistry, 1915, p. 672. The central nervous system is responsible both for emotion and for the stimulation of the sympathetic system ; only the sympathetic stimulates the supra¬ renals to secrete epinephrin, which in its turn makes the sympathetic innervation more efficacious. It is like a process of autocatalysis, the sympathetic system, as it is stimulated, automatically raising the efficacy of its own stimulation. Despite these diverse interesting facts that are known about epinephrin, it must not be concluded that the liberation of this compound represents the sum total of the functions of the suprarenal bodies. Extir¬ pation of these structures invariably results in death ; but the symptoms which precede it are scarcely ameli¬ orated, nor has the fatal outcome been prevented by the injection of epinephrin. Stewart and Rogoff2 have shown that after section of the nerve supply of the suprarenals in animals there was no demonstrable liberation of epinephrin into the circulation, for some weeks at least, after the opera¬ tion. It is highly probable, therefore, that the entire secretion of this hormone from the glands is con¬ trolled by the nervous system. Furthermore, in a series of new experiments in which one suprarenal was excised and the nerves of the other severed, the animals recovered completely from the operation and behaved in every way like normal animajs. It must be concluded, therefore, that the liberation of epi¬ nephrin from the suprarenals is not indispensable for life or health, unless, indeed, the necessary quantity, even in the suprarenal vein blood, is below the limits of detection by the methods used. The real cause of death after loss of the suprarenals remains to be elucidated, nor is there yet any adequate explanation of the pigmentation of the skin in Addison's disease. THE ANTINEURITIC PROPERTIES OF MILK "It is well to be on the right side of facts, for they are stubborn things and insist on being respected." This dictum deserves to be reiterated with strong emphasis at a time when shortage of food is confronting millions of people and when the possibilities of specific deficiencies in food products and the introduction of "devitalized" foods as a result of current methods of food manipulation are being widely discussed. In urging young men to "first get the facts," the secretary of commerce has said: The relation men hold to truth, their respect for facts, their use of facts, largely determines their place and power in life. We make progress in the business world not necessarily by research for facts but at least by outreach for them and by respectful treatment of them when they are found. The amount of success will depend a good deal upon how far your vision goes in seeing the facts that surround you and on the
doi:10.1001/jama.1917.02590280042015 fatcat:negce5bjlfg6jix7zvynqe7spe