ADRENALECTOMY 159 



Wislocki 141 excised the left adrenal of cats, rabbits, and dogs, 

 removed half of the right gland, and cauterized the medullary 

 substance in the remaining half of the gland. Subsequent 

 histological examination of the adrenal tissue revealed in some 

 cases complete absence of any medullary tissue. Neverthe- 

 less the animals survived for long periods in good health. 

 Pende 493 and Stewart and Rogoff 587 excised one adrenal and 

 denervated the remaining gland. Although no epinephrine 

 could be detected in the blood draining the remaining gland, 

 the animals remained in good condition indicating that lack of 

 epinephrine was not the cause of the deficiences observed after 

 adrenalectomy. Houssay and Lewis 311 split the left adrenals 

 of dogs, scooped out the medulla, and ten days later excised 

 the right gland. Their animals remained entirely normal. 

 At autopsy, histological examination of the adrenals revealed 

 complete absence of the medullary tissue. 



The extirpation of the interrenal bodies of the elasmobranch 

 fishes leads, as we have seen, to an insufficiency resembling 

 that which follows adrenalectomy in mammals. The fact that 

 extracts prepared from this purely cortical tissue serves as a 

 replacement therapy in the insufficiency of mammals which 

 follows adrenalectomy is further evidence that it is the absence 

 of the cortex which is responsible for these manifestations. 250 



It requires only a small remnant of the adrenal cortex to 

 support life. As was first shown by Langlois, 380 one-sixth to 

 one-eleventh of the total cortex suffices to preserve life. Ac- 

 cording to Biedl, 56 about one-eighth is necessary; according to 

 Wislocki and Crowe, 685 about one-fifth; and according to 

 Bornstein and Gremels, 70 one-fourth. From our previous 

 considerations it is evident that the fraction necessary will 

 depend upon the conditions observed in performing the opera- 

 tion. In fact in rats, as we have seen, even an invisible group 

 of cortical cells may suffice after their hypertrophy to maintain 

 normal life. 



That it is the cortical tissue and not the medullary which is 



