140 INTERNAL SECRETION 



very frequently found in the vicinity of the vena cava and 

 vena suprarenalis. In his view, the suppression of the suprarenal 

 function causes a strong proliferation of the isolated suprarenal 

 bodies which, in the embryonal stage, split off from the main 

 organs. This proliferation produces a compensatory hypertrophy 

 which may end by completely replacing the suppressed suprarenal 

 function. 



Stilling's suggestive work contains the important statement 

 that these newly-formed, accessory suprarenals possess a structure 

 resembling that of the cortical substance, and that they contain no 

 medullary tissue. Stilling, moreover, was the first to describe cells 

 structurally similar to those of the suprarenal medulla. These 

 cells stain brown with the chromium salts ; and they are found, 

 sometimes singly and sometimes formed into small bodies with a 

 structure similar to that of the medulla, in the ganglia of the 

 abdominal sympathetic and in the intercarotid ganglion. 

 Stilling thinks that, owing to the presence of these cells, a pro- 

 portion of medullary substance is present in animals from which 

 both suprarenals have been removed. This, in combination with 

 the fact that the cortical substance is always built up again by 

 accessory suprarenals, explains the impossibility of completely 

 destroying the suprarenals and of producing the clinical complex 

 of Addison's disease experimentally in animals. The Addison's 

 disease of human pathology is due to the destruction of the 

 suparenals, and perhaps also of the structures by which the 

 suprarenal function may be replaced. Enlargement of the 

 accessory suprarenals and of the chromophile bodies would 

 explain the occurrence of suprarenal derangement unaccompanied 

 by Addisonian symptoms. 



Stilling's work did not receive the recognition which it 

 deserved. It appeared at a time when physiologists were first 

 beginning to understand the importance of the blood glands. 

 Brown-Sequard had introduced his theory of the internal secre- 

 tions, and had expressed his conviction of the necessity of the 

 suprarenals to the life of the organism. Stilling's discoveries 

 seemed to contradict this view. 



In Richet's physiological laboratory, a number of experi- 

 ments were undertaken with the object of determining the essential 

 character of the suprarenal function. Special attention was 

 devoted to the technique of these experiments, and the removal of 

 the suprarenals was effected according to the most approved rules 

 of modern surgery. 



Abelous and Langlois (1891) next showed that, in frogs, the 

 destruction of one suprarenal is not attended by results ; but that 

 the destruction of both glands invariably causes death, winter 

 frogs living for twelve to thirteen days and summer frogs dying at 

 the end of forty-eight hours. The animals also die after partial 

 destruction of both suprarenals, unless at least a quarter of each 



