Cardiac insufficiency due to high arterial pressure

Prof. Leo Loeb, of the University of Pennsylvania, first called my attention to the method of teaching the phenomena of pulmonary edema by administering massive doses of adrenalin to rabbits. His observations I repeated with similar, although not such severe results, in June, 1906, in one instance following the signs of mitral regurgitation and acute dilation of the heart through to a gradual recovery, and finally complete reestablishment of the normal heart sounds and heart rate in a rabbit.

During the winter of 1906-7 in the course of demonstrating the effects of direct and reflex vaso-motor phenomena to students, I had occasion to observe the effect of massive doses of adrenalin in cats, in which the carotid blood pressure and the intrapleural pressure variations were being recorded on a kymograph. The familiar phenomena of blood pressure, raised and maintained to 250-300 mm. of mercury, with a rapid respiration were observed, the usual slowing of the heart not appearing in these extreme conditions. In every instance there appeared shortly, small and then large moist rales over the entire chest, which gradually increased until the tracheotomy tube became flooded with serous froth. Often the systolic regurgitant murmur and the irregular rapid heart sounds were noticed preceding the edema.

If it had not been for a further observation I should not have ventured to bring this to your attention, but during June, 1907, I had occasion again to demonstrate the physical signs and physiological records in cats under heavy doses of adrenalin. To provide a more complete picture of the cardiac and pulmonary changes I used a cat under ether with the anterior chest wall removed and artificial respiration established. This cat, like another on an adjoining table, under normal respiration, showed the high blood pressure, and presently the moisture accumulating in the trachea.