1 68 INTERNAL SECRETION 



of recovery from Addison's disease. Kinnicut publishes the 

 statistics of forty-eight cases of Addison's disease which were 

 treated by organo-therapeutic measures. Of these, in two cases 

 there was aggravation of the condition ; in eighteen, the condition 

 remained unchanged; in twenty-two, there was an improvement; 

 and in six cases there was complete recovery. 



It is evident from this that the treatment of Addison's disease 

 by means of suprarenal extract is very variable in its results. The 

 few cases of recovery are nullified by those where an aggravation 

 of the condition ensued. In the large majority of instances the 

 treatment produced negative results or the amelioration of single 

 symptoms only. The muscular weakness and the digestive 

 derangements appear to be the symptoms most favourably 

 influenced. 



That suprarenal extract, when given by the mouth, should 

 affect the reduced cardiac activity, and the lowered blood-pressure 

 is hardly to be expected. Nevertheless, Griinbaum asserts that, 

 although suprarenal extract, when given by the mouth, does not 

 raise the blood-pressure of normal subjects, it does have that 

 effect when given to persons suffering from Addison's disease. 

 Falta has recently shown that in man, the subcutaneous injection 

 of adrenalin brings about a rise in blood-pressure. 



The symptom which is least affected by this method of treat- 

 ment is undoubtedly the pigmentation. 



The foregoing accounts of the effects of suprarenal extract in 

 Addison's disease suggest certain definite ideas. Of these, the 

 most important concerns the influence of adrenalin upon the 

 symptoms. But a certain measure of efficacy must be ascribed to 

 other substances present in suprarenal extract, and notably those 

 which are derived from the suprarenal cortex. Experiments with 

 animals seem to suggest that the exhibition of suprarenal 

 substances in Addison's disease provokes hypertrophy of the 

 portions of the organ which, in this condition, undoubtedly 

 remain intact, and that by this means the functional inadequacy 

 of the organ is reduced in a quantitative sense. The negative and 

 harmful effects of suprarenal treatment are probably seen in those 

 cases where the suprarenals have become completely destroyed. 



TRANSPLANTATION OF THE SUPRARENALS. 



The second method of suprarenal substitution is that of the 

 surgical transplantation of the organ. In 1887 Canalis attempted 

 the implantation in the kidney of small portions of suprarenal 

 tissue, but the results which he obtained were purely negative, 

 the implanted portions becoming necrosed and undergoing 

 resorption. The experiments of Abelous, and later those of 

 Abelous and Langlois, with frogs were equally unsuccessful. 

 Courfein implanted the suprarenals of frogs and guinea-pigs in 



