200 CORTEX 



pation of one adrenal and denervation or removal of the 

 medulla of the remaining gland might be expected to cause a 

 temporary slight degree of cortical insufficiency. Hence the 

 demonstration of hypoglycemia soon after such operations is 

 no evidence that the medullary deficiency is responsible for 

 the observed effects. It is only after sufficient time has 

 elapsed for the normal secretion of the cortical hormone to 

 adjust itself by hypertrophy of the remaining cortex that one 

 is justified in interpreting the observed effects as due to medul- 

 lary deficiency. Under these conditions it has been repeatedly 

 demonstrated that no abnormalities of the carbohydrate con- 

 tent of the blood, liver or muscles occur under normal condi- 

 tions. We can, therefore, conclude that the hypoglycemia and 

 reduced glycogen content of the tissues observed in adrenalec- 

 tomized animals is due to cortical insufficiency. In Addison's 

 disease the hypoglycemia which occurs in some cases is like- 

 wise attributable to the cortical insufficiency. 



There is some evidence that the mobilization of glycogen 

 from glucose is interfered with in the absence of an adequate 

 supply of the cortical hormone. Thus in dogs, 48 hours after 

 adrenalectomy, injected glucose disappears slowly; and muscu- 

 lar glycogen is not increased unless one injects the adrenal 

 cortical hormone or insulin. 386 Although the muscle glycogen 

 may be normal a day or two following adrenalectomy in the 

 dog, it rapidly disappears after muscular fatigue and its re- 

 synthesis proceeds very slowly. Normally the muscle glyco- 

 gen is rapidly restored after its diminution by severe exercise. 

 After adrenalectomy, however, this restoration is greatly de- 

 layed. Intravenous injection of glucose does not appreciably 

 hasten the resynthesis of glycogen, while the administration 

 of the cortical hormone results in a rapid restoration of the 

 normal glycogen content. 160 The cortical hormone is thus 

 essential either for the normal synthesis of glycogen by the 

 muscle or for maintaining the normal balance between the 

 blood sugar and the glycogen of the various tissues. 3S6 



