On the excretion of reduction products of haematin in disease / by C.A. MacMunn.
- MacMunn, Charles Alexander, 1852-1911.
- Date:
- 1888
Licence: Public Domain Mark
Credit: On the excretion of reduction products of haematin in disease / by C.A. MacMunn. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![1] un argiunenl against the theory adopted liere, because llie adreiuilw being 8up])leinentury organs, other organs may do duty tor them to a grciat extent, under certain unknown conditions. Besides, if Addison's disease were to occur in a patient in whom by previous disease the iiiieinoglobins and the liistohiematins liad been diminished in amount, we should not expect to meet witli mucli ell'ete pigment in that case.''' And even it' tlie adrenals are apparently luniithy, we cttnnf)t always say whether there has not been some interference Avith their nervous or arterial 8up]>ly suihcient to prevent the discharge of their functions. Looking over tlie recent literature of this subject, one finds some very interesting cases of Addison's disease described. In the case re- corded by Dr. Wickham Legg,' there were shortness of breath, giddiness and vomiting, bronzing of skin, and paroxysm of fever, m Monti's case there were several febrile attacks during th« course of the case, drowsiness and heavy sleej^s, excitement, delirium, and loss of consciousness, and death took place in a con- vulsion. In Rauschenbach's^ case there were rigors and heat at the beginning of the illness, restlessness, delirium, and various nervous symptoms. In Cacciola's-^ case febrile attacks were also noticed, and the patient became delirious before death, and died in a convulsion. In some of these cases the nervous symptoms and the hj^per- thermia are very remarkable (especially as it has been said the temperature is subnormal in Addison's disease, which is a A'ery doubtful statement), and these symptoms are explicable only on the assumption that some toxic substance or substances must have been present in the blood. That such is the case seems more than probable from the experiments of Foa and Pellacani,^^ w^hich have not met with the attention which they deserve. These observers injected an aqueous Altered extract from certain organs, namely, the brain, the testis, and the adrenals, into the veins of rabbits, and found that death ensued, which was due to coagulation of the blood in the heart and lesser circulation. They proA'ed that a fibrinogenous ferment, both chemically and physiologically active, was present in the solutions, wdiich is due not to the blood circulating in these organs, nor to destruction of white corpuscles in them, but to a substance present in the organs; and when the solutions injected were little active, marasmus was produced, from which the animal died. But here is the most important result; they found that aqueous and alcohol extracts of the adrenals had a most toxic effect, an effect peculiar to the extracts of these organs. The poison present in the adrenals is more like an organic acid or a ptomatin in its action; it paralyses the spinal cord, etc., and causes death by paralysing the bulbar centre, and especially the respiratory centre. Is this, then, the product of proteid disinte- gration which it is the province of the adrenals to pick out of the circulation and metabolise into a harmless substance, and which, when these organs are diseased, accumidates in the blood, and pro- duces nervous symptoms and hj^^erthermia; for Foa and Pellacani found that it also produced increase of temperature ? We know that the poisonous alkaloids of animal origin, the 1' In the adrenals from a case of pernicious anjemia sent me by Dr. W. Rus- Bell, of Edinburgh, the bands were extremely faint. 18 Lancet, June. 1885, p. 1027. Med. Eec, vol. xiii. 19 Archivf iir Kinderheilkunde, Band vi, Heft. 4. 20 Vratch, No. 1, 1886. , „ „ . 21 Gazz. Med. Ital. Prov. Venet., No. 5, 1884; Giornale Intemaz. delle Set. Med. Faxc, viii, 1884. . , . . -n jo,. 22 Arch. per. le Sc. Med., vii, 9, ;i885 ; and Schmidt's Jahrbucher, Band 31», 1836.](https://iiif.wellcomecollection.org/image/b22302475_0008.jp2/full/800%2C/0/default.jpg)
