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From The Division of Pharmacology, Hygienic Laboratory, Public Health An4 Marine Hospital Service, Washington, D. C
From The Division of Pharmacology, Hygienic Laboratory, Public Health An4 Marine Hospital Service, Washington, D. C
TESTING ADRENALIN
W. H. SCHULTZ
From the Division of Pharmacology, Hygienic Laboratory, Public Health an4 Marine
Hospital Service, Washington, D. C.
\
This OnS
CD22_479_X96G
292 W. H. SCHULTZ
in pairs. After first observing the eyes the solution to be tested was
dropped upon the corneal surface of one eye of a given pair and upon
its companion an equivalent amount of salt solution, whereupon the
eyes were again observed for one or two hours. As the result of six
experiments it is concluded that d-adrenalin does not affect the ex-
cised eye of the frog, but that the 1- product does, and since dl-adrena-
lin dilates the pupil, it does so by virtue of the lavo component in
the racemic product. Furthermore, d-adrenalin does not produce
glycosuria, the 1avo does, hence when it is thus produced the 1-,
not the d- product, is responsible.
Abderhalden and Slavu (1), 1909, studied the effect of subcutaneous
injections of adrenalin upon mice. In animals weighing from 11 to
14 grams an injection of 0.1 to 0.2 milligram of 1-adrenalin caused
the temperature to fall as much as 15.5#{176}C., the animal usually dying
when the temperature fell to 22#{176}
or 23#{176}
C. If, however, d-adrenalin
was used, a 13-gram mouse could be injected with as much as 5 milli-
grams with but slight change in temperature and no perceptible after
effects. An 11-gram mouse was injected daily with doses of increas-
ing size, starting with 1 milligram until a 5-milligram dose of d-adren-
alin was reached after which the mouse recovered from an 0.8-milli-
gram dose of 1-adrenalin, which, according to these writers, is eight
times the lethal dose. From this they infer that the d- product
causes more or less tolerance towards 1-adrenalin, and that the differ-
ence in their action is the result of physical differences present in the
two substances.
Comessatti (3), 1909, used the excised eyes of 1?. temporaria and
Hyla arborea in a comparative study of the mydriatic substances in
urine and serum and of adrenalin solutions. One eye was placed in
Ringer’s solution, the other in serum, urine, or the substance to be
tested and both illuminated by electric light. Observations were
made for a period of two hours.
TJndialyzed urine brought about opaquing of the lens and so it
was dialyzed for two or three hours in a Philippson tube, which re-
moved the substance responsible for the opalescence. Comessatti also
experimented with 5, 2.5, 1.25, 1, 0.6, 0.50, 0.30, and 0.25 per cent.
sodium chloride solutions and found that saline solutions do not
cause prompt dilation of the pupil, but 1.25 per cent. and over cause
CRITICISM OF RECENT RESULTS IN TESTING ADRENALIN 293
My own experience has been that the length of the pupillary axis
ought to increase by at least 0.4 to 0.5 mm. and maintain this length
within a few hundredths of a millimeter in order to eliminate the
possibility of the eye having dilated in response to mechanical or
thermal stimuli. In other words, if an eye in adrenalin solution
dilates to maximum in 30 minutes and immediately begins to con-
strict, returning to normal within two or three hours, it is almost
certain that the dilation noted during the first thirty minutes was
not necessarily due tO adrenalin.
A 1:125,000 solution of natural 1-adrenalin may cause the pupil to
dilate more widely than does a 1:1000 solution. And in the course
of dilation it is not always the short axis that dilates most rapidly,
though this may seem to be the case when observed by the naked
eye. Measurements show that the long axis often increases in length
more rapidly than does the short one, and upon reaching a (see 42b
and 48b) maximum length it then comes to a standstill or decreases
in length while the short axis gradually reaches its greatest length.
Then, like the long axis, it usually decreases in length and finally
comes to rest, whereupon both axes remain stationary or oscillate in
length slightly. At this time the pupil may be round, oval, or irregular,
depending upon the eye used.
It would seem that the degree of mydriasis is not proportional to
the strength of the adreralin solution. Data with reference to this
are clearly brought out in tables I and II, in which experiments 37b,
48b, 52b, 56b, and 59b are all with eyes of approximately the same
size, yet they do not show that a definite relation exists between
the amount of dilation and the concentration of the solution used.
The degree of adrenalin reaction should instead be sought for in what
may be called the maximum dilation time. For although solutions
of adrenalin do not necessarily cause a degree of mydriasis in propor-
tion to their concentration, the more concentrated solutions require
a shorter time in which to bring about maximum mydriasis.3 Even
By maximum mydriasis is meant the greatest length of one or both pupillary
axes acquired under existing experimental conditions, not the greatest possible
dilation for the eye to attain under normal conditions. Thus, with a given drug the
axes may increase in length up to a certain point and no further, after which they
either shorten or remain stationary. This greatest length is almost invariably less
than that attained in the normal eye when dilated to its greatest possible size, as
in very dim light.
CRITICISM OF RECENT RESULTS IN TESTING ADRENALIN 297
this unit is not to be relied upon when eyes are chosen promiscu-
ously as in tables I and II. It is, however, very reliable when eyes
of freshly caught frogs are studied in pairs so that the right and left
eye of a given frog are immersed, say, in 2 cc. of a 1:20,000 or in a
1:40,000 solution of adrenalin at 20 or 26#{176}
0.
It would seem that there is a certain optimum concentration in
which adrenalin acts most uniformly upon the enucleated frog’s eye.
This optimum concentration, though varying somewhat with indi-
viduals, is approximately one part of adrenalin base to 20,000 of
Ringer solution. With such a solution at 20#{176}
the dilation time is
about 27 minutes. If more concentrated solutions be used there will
be a gradual shortening of this time until a certain per cent. (again
depending upon the individual) of adrenalin content is reached, after
which further increase of concentration fails to shorten the time
required for the axes to reach their greatest length. Thus it is pos-
sible to choose a set of solutions of such concentration that all produce
a maximum mydriatic effect, though some members of the set con-
tain ten times as much adrenalin per cc. as do others. Naturally,
the dilation time of eyes immersed in such solutions will be about
the same. If, on the other hand, weak solutions are used which con-
tain less than 1:625,000, the dilation time at 20#{176}
to 23#{176}
becomes variable
and the degree of mydriasis is usually so small as to be of uncertain
origin. For comparative work, whether quantitative or qualitative
in nature, it would seem then advisable to limit the experiments, at
23#{176}
C., to solutions containing not more than one part of adrenalin
base to 10,000 parts of Ringer and not less than one of adrenalin to
125,000 of Ringer and certainly not less than 1: 625,000.
Finally, to those interested in a clinical method for determining
the presence of adrenalin in body fluids the pupil method is, according
to Ehrmann and others, an exceedingly delicate and reliable test-
object. Yet in the light of my own experiments I cannot recommend
it in such strong terms as do these writers. If the excised eye yields
uncertain results when immersed in a 1:625,000 Ringer adrenalin
solution of known composition, what must one expect with a patho-
logical serum the adrenalin content of which is undoubtedly less than
this, not to mention the possible influence of other less well-known
substances that by their combined action may cause the slight
mydriasis often observed with such sera?
298 w. H. SCHULTZ
TABLE I
Mydriatic Action of Natural i-Adrenalin and of Synthetic di-Adrenalin
(Excised eyes of Rana halecina, Kalm)
.# .a ia
CONCEN-
TABLE II
Mydriatic Action of Nalural i-Adrenalin and of Synthetic di-Adrenolin
(Excised eyes of Rana halecina, Kalm)
I
I9u.cI 9,C
-e
CONCEN- Increase in
No Temp Increase n TRATION
OF SOLN. No. Temp.
of of length of of of length of d
Exp. 5n. axes 1 GM. PER Exp. :
Soln axes
e4
‘3,_sI oi.
.E, 2S
45a 22.2 0.410 0.430 114 625000cc. 45b 22.2 0.180 0.040 174
22.4 0.310 0.440 118 Ringer 22.4 0.060 0.060 51
The figures in Tables I and II represent the changes in the length of the long and short axes
of the pupil measured by the pupilometer described in a previous article (8). The excised bulbi
were placed in glass containers of about c.c. capacity, kept at a constant temperature and a
light intensity equivalent to that of 16 c. p. incandescent light 10 inches away. The normal or
zero reading is of the constricted pupil in Ringer solution, at the temperature given in the tables.
After once bringing the eye to a given temperature the solution in which it was studied was
brought to the same temperature, especial care being taken not to disturb the eye in trans-
fering the solutions.
300 W. H. SCHULTZ