PATHOLOGY OF CORTICAL INSUFFICIENCY 175 



with Sudan III large quantities of lipoidal substances were 

 found. These lipids were in the form of droplets in the tubu- 

 lar epithelium and corresponded to the vacuoles which were 

 observed in paraffin sections. Banting and Gairns 31 also de- 

 scribed hyperemia of the kidney, swelling of the tubules, and 

 albuminous casts containing blood cells in the lumina of the 

 tubules in dogs which had died of adrenal insufficiency.* 



LYMPHATIC SYSTEM 



Hypertrophic changes in the lymphatic system associated 

 with loss of adrenal cortical function due to disease or experi- 

 mental ablation have been frequently observed. 335 These 

 changes in the lymphatic tissues were first noted in Addison's 

 disease. During life one may observe enlargement of the 

 lymphatic nodules at the base of the tongue and of the tonsils 

 and other palpable lymphatic tissues. At autopsy there is 

 marked enlargement of Peyer's patches and isolated follicles 

 in the gastro-intestinal tract and mesentery. Star 585 first 

 noted the persistence of the thymus in patients dying of Ad- 

 dison's disease. The spleen often shows a moderate enlarge- 

 ment with hyperplasia of the follicles. Indeed, the general 

 lymphatic enlargement sometimes seen in Addison's patients 

 resembles that of the so-called "status lymphaticus." 335 



Animals dying of chronic adrenal insufficiency also show a 

 striking hypertrophy and regeneration of the thymus and 

 lymphatic tissues generally. The changes in the thymus of 

 the rat after adrenalectomy have been studied in detail by 

 Jaffe. 331 In young animals adrenalectomy stimulates the 

 growth of the thymus while in mature animals active regener- 

 ation of the thymic tissue occurs. At autopsy, huge thymic 

 glands are encountered. In larger mammals the short period 

 of survival which follows adrenalectomy does not allow time 

 for any regeneration of the thymus. In cats and dogs main- 

 tained for long periods on minimal doses of the cortical hor- 

 mone, this hypertrophy is, however, very prominent. 



The lymph nodes of animals in adrenal insufficiency are also 



* Cf. also Jour. Path, and Bact. vol. 40, p. 483. 



