By cooling fresh suprarenal gland tissue immediately on removal from the animal, and by defatting, and mincing the same at low temperatures, and drying at 37°C. with the least loss of time, a preparation is obtained which in daily doses of 3 grm. per os, is effective in restoring a large measure of health to sufferers from Addison's disease.It is essential that a potent extract of suprarenal cortex be available for ( a) restoring the patient sufficiently to enable whole gland treatment to be instituted and ( b) to treat any return of abdominal symptoms or circulatory collapse induced by intercurrent illness or failure to retain the whole gland through vomiting.It is desirable to increase the intake of sodium chloride to 10 to 15 grm. daily.Neither saline alone, nor cortical extract alone produces the same effective result as whole suprarenal gland prepared as above administered per os.Commercial preparations of whole suprarenal can be entirely without effect.Subcutaneous injection of adrenalin in a phase of weakness may have disastrous results.Trials, using the whole gland preparation on normal subjects, further establish the observations of Rowntree, that the gastric musculature is stimulated by injection of whole suprarenal gland. In certain cases, considerable elevation of blood-pressure may also result.
A case of extreme wasting associated with amenorrhœa for eighteen months. On finding that the subject showed a fall of blood-pressure with unaltered pulse-rate on sitting up, anterior pituitary dysfunction (Simmonds' syndrome (?)) was diagnosed and prolan (Bayer) was administered. Following 100 units intramuscularly administered, the circulatory response became normal in twenty-four hours. The pulse rapidly improved in strength and all circulatory symptoms disappeared within a week. Weight increased at first rapidly, and the nutrition, skin and hair improved remarkably. Metabolism of sugar, as shown by glucose tolerance tests, became normal, and evidence for improvement in fat metabolism is brought forward. The study of the case goes to support the conclusion of Schellong that a function of the anterior pituitary is to influence the circulatory response to muscular effort. That hypotonia of itself is not responsible for the circulatory symptoms is shown by the failure of ephedrine (which raised the blood-pressure) to remove the circulatory symptoms. Contrary to some accepted beliefs, prolan, which is prepared from urine of pregnant mares, has a profound metabolic effect, as well as an effect on the ovary. The diagnostic value of the circulatory response in doubtful cases is discussed.
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