THE ACTION OF ADRENALIN IN NEUROTICS.

Abstract

SINCE Cannon (1915) demonstrated that emotional stress is associated with an increased and prolonged secretion of adrenalin, attention has been directed to the relationship of the effects of adrenalin and the symptoms of anxiety. Maranon (1924), giving subcutaneous injections of the drug, observed effects varying from a vague apprehension to severe emotional disturbance and concluded that an exaggerated response is shown by anxiety neurotics. He demonstrated that emotion is not directly determined by the physical phenomena and that intense physical reaction can occur without emotional response. The emotion may not necessarily be that of fear, and a case experiencing great joy was described. Richter (1940) suggested that the emotional response may be due to the physical effects of the injection and claimed to have eliminated this by the introduction of adrenalin electrically through the skin. By this method he confirmed Maranon's findings, agreed that emotions other than fear may occur, and described an asthmatic who experienced a sensation of confidence after injection. He concluded that conaesthetic impulses arising from visceral disturbances excite an emotionally charged cortical pattern so that each tends to increase the degree of excitation of the other. Lindemann and Finesinger (1938) injected mecholyl and adrenalin intramuscularly into a group of neurotics. They objected to the intravenous route on the grounds of the rapid rise and fall of blood pressure which occurs and preferred the slower intramuscular route as it gave time for more prolonged observation. They found four groups: (1) specific response to adrenalin, (2) specific response to mecholyl, (3) reaction to both drugs, (4) no response to either. In the adrenalin-sensitive group the anxiety attacks were found to be unrelated to specific situations or mental content and were thought to coincide with Freud's " actual neurosis." The mecholyl-sensitive group were those with definite phobias and fears. The mixed group had a history of autonomic instability and hypochondriasis and the last group indicated more profound personality disorders. The writers recorded that in the adrenalin attack there is a surrender to anxiety, associated with diminished speech production, while in the mecholyl attack there is an active attitude directed to the environment, with increased speech production, associated with phobic states. 14 coright.