ADRENALECTOMY 157 



easily accessible through a posterior extra-peritoneal approach 

 and may be readily extirpated. Kahn 345 first performed this 

 operation in a monkey and found that the course of the result- 

 ing insufficiency was similar to that observed in other mammals. 

 Recent investigators have confirmed Kahn's results. 198 The 

 reported development of pigmentation in a monkey maintained 

 on an apparently inadequate dose of the cortical hormone 267 

 would indicate that this species may be useful in studying this 

 phenomenon which is so striking a symptom in the adrenal 

 insufficiency of man. 



Moore and Purinton 459 performed adrenalectomy in several 

 goats. Their results indicate an exceptionally long survival 

 in this animal. Since the goat is unusually well adapted for 

 studies of the metabolism, blood chemistry, circulation, etc., 

 it should prove superior to the more common laboratory 

 animals for many experimental studies on adrenal insufficiency. 



The results of adrenalectomy in the opossum (Didelphys 

 virginiana), the squirrel (Sciurus carolinensis) and the marmot 

 (Arctomys monax) do not differ materially from those ob- 

 served in the cat or dog. 86 



THE r6lE OF ACCESSORY BODIES 



Death may often occur following adrenal insufficiency even 

 in the presence of accessory tissue. Examination of such tissue 

 at autopsy will show interstitial fibrosis, vacuolization, in- 

 filtration of giant cells, and, in general, a picture indicative of 

 "exhaustion atrophy." 335 Apparently under certain conditions 

 the accessory tissue or remnants of the main gland are unable, 

 due to inadequate blood supply, perhaps, to undergo hyper- 

 trophy. Consequently they function for a short while but 

 eventually become exhausted. Such exhausted tissue is often 

 encountered in rats dying of chronic insufficiency several months 

 after adrenalectomy. Accessory tissue in cats or dogs is 

 often incapable of maintaining life after adrenalectomy. How- 

 ever, maintenance of such animals for a week or more on the 



