146 CORTEX 



nests of accessory cortical tissue which lie in the vicinity of the 

 main glands may hypertrophy to a sufficient degree to permit 

 indefinite survival of the animal in good health after a pre- 

 liminary period of mild insufficiency. In such cases macro- 

 scopic examination will reveal the presence of the hypertrophied 

 glandular material. The occurrence of such hypertrophy has 

 long been recognized. However, it has not been generally 

 recognized that, although such remnants may be undetectable 

 by the usual macroscopic necropsy, they may suffice to prolong 

 life for some time. 



Microscopic examination of the connective tissue of the 

 space occupied by the adrenals will often reveal in animals that 

 have survived an unusually long time after adrenalectomy the 

 existence of exhausted cortical cells. These cells apparently 

 functioned for a time but eventually, due perhaps to poor 

 vascularization or other factors preventing their multiplication, 

 were unable to maintain the fife of the animal. The existence 

 of such exhausted adrenal tissue must be borne in mind in 

 testing the therapeutic efficacy of any preparation. Failure 

 to examine microscopically the adrenal sites at autopsy may 

 explain some of the claims for the therapeutic value of extracts 

 which later work has shown to be utterly worthless. Mere 

 macroscopic search for accessories as performed by most 

 recent workers in proving the completeness of their adrenal- 

 ectomies is no valid proof of a complete extirpation. Micro- 

 scopic search must also be made for the exhausted nests of cells 

 described above. 



Post-operative care. The post-operative care of adrenalec- 

 tomized animals is important in determining the length of 

 their survival. They should be maintained at an equable 

 temperature, free of all excitement. Excessive exercise should 

 be avoided. A relished diet high in salts and carbohydrate is 

 desirable. The ingestion of high protein diets reduces the sur- 

 vival period. 31 ' 267 



