250 INTERNAL SECRETION 



by toxins. Charrin and Langlois found that the injection of 

 pyocyaneus toxin was followed by pronounced hypenemia and 

 increase in the volume of the suprarenals, and Pettit observed 

 histological degenerative changes. Bogomolez discovered serious 

 changes in the suprarenals, namely, necrosed and hemorrhagic 

 areas, after infection with diphtheria bacilli ; and Tscherwenzow 

 observed similar signs after infection with plague bacilli, Labzine 

 after streptococcus infection. 



According to Langlois, the amount of the active substance 

 which raises blood-pressure is apparently unchanged in the hyper- 

 aemic suprarenal ; while, after chronic infective conditions, the 

 capsule, though increased to three or even four times its original 

 volume, yields extracts which are totally inactive. According to 

 Luksch, the suprarenals of rabbits poisoned with diphtheria toxin 

 or by the injection of other bacterial toxins (tuberculosis, typhus), 

 do not contain a substance which either raises blood-pressure or 

 produces enlargement of the pupil. This author also found that 

 suprarenal extract obtained from ura^mic animals or those poisoned 

 with phosphorus, is inactive, but that positive results were yielded 

 by extracts obtained after hunger, fever, poisoning with hydro- 

 chloric acicl, and resection of the spinal cord. 



Schur and Wiesel found adrenalin in the blood after double 

 nephrectomy, and after the excision of wedge-shaped pieces from 

 the kidneys ; there was, moreover, a change in the chromaffinity 

 of the suprarenals, the medullary substance containing cell- 

 groups which were strongly chromophile, together with other 

 groups which were achromophile. After prolonged renal injury, 

 both the suprarenal medulla and the free chromaffine bodies 

 present appearances which suggest hypertrophy of the chromaffine 

 tissue. 



Molnar and Goldzieher found adrenalin in the blood of rabbits 

 after the subcutaneous injection of pounded and rubbed-down 

 kidney. They also found histological signs of hypertrophy in 

 the suprarenals in thirty clinical cases of chronic nephritis. 



There has been, up to now, no systematic investigation of the 

 adrenalin contents of the suprarenals in different clinical condi- 

 tions ; and exact information as to the amount of adrenalin present 

 in the suprarenals in Addison's disease is particularly scanty. In 

 two cases of Addison's disease, I found that the extract obtained 

 from the suprarenals, which had undergone serious pathological 

 changes, when injected intravenously, produced no effect upon the 

 blood-pressure. In a clinical case described by Neusser, which 

 he believed to be one of suprarenal hypertrophy, I found that the 

 extract obtained from the suprarenal, which had undergone pro- 

 nounced carcinomatous degeneration, was exceptionally active. A 

 portion of a suprarenal, obtained from a case of extreme cardiac 

 hypertrophy, which was handed over to me by my colleague Stork, 

 yielded an extract with strong hypertensive properties. On the 



