CARBOHYDRATE METABOLISM 199 



cemia was accompanied by a reduction of the glycogen content 

 of the liver, the glycogen content of the gastrocnemius muscle 

 remaining normal. Porges also demonstrated the occurrence 

 of hypoglycemia in some patients suffering from Addison's 

 disease. Schwartz 559 showed that after adrenalectomy the 

 glycogen of the liver of rats might vanish. Other authors have 

 repeatedly confirmed the above results which indicate a tend- 

 ency to hypoglycemia and a reduction in the glycogen store 

 of the liver and muscles in animals in adrenal cortical insuffi- 

 ciency. The results of Stewart and Rogoff, 588 who found nor- 

 mal values in adrenalectomized rabbits, are obviously due to 

 the absence of any cortical insufficiency in their animals. The 

 completeness of the operation and the time allowed to elapse 

 before making the observations will determine the result 

 obtained. As hypertrophy of accessory bodies and unextir- 

 pated remnants of the main gland proceeds, the degree of 

 cortical insufficiency diminishes and the signs of an abnormal 

 carbohydrate metabolism disappear. There always remains, 

 however, any abnormal sensitivity which may be due to 

 absence of the medullary tissue. 



The hypoglycemia of adrenal insufficiency is in no way the 

 result of failure of the medullary secretion but is entirely the 

 result of absence of the hormone elaborated by the cortex. 

 This is shown by the experiments of Houssay and Lewis 311 who 

 extirpated the medulla from dogs leaving the cortical tissue 

 intact. In such animals in which no medullary tissue was 

 demonstrable, the blood sugar was normal. B0ggild 65 has also 

 demonstrated that it is the cortex which is responsible for the 

 hypoglycemia which follows adrenalectomy. In depancrea- 

 tized animals the blood sugar level was not affected by removal 

 of the medulla in severe diabetes, but a slight reduction fol- 

 lowed in mild cases. Nor as Leloir 386 has shown does unilateral 

 adrenalectomy with denervation of the remaining adrenal, 

 modify the intensity of pancreatic diabetes. This operation 

 does not affect the blood sugar level of normal animals. Extir- 



