Chapter XXIV 



OTHER PATHOLOGICAL ABNORMALITIES OF THE 

 ADRENALS 



Besides the destructive lesions of the adrenals which give 

 rise to Addison's disease and the tumors of the adrenals dis- 

 cussed in previous chapters, a number of pathological condi- 

 tions are accompanied by abnormalities of the adrenals. The 

 significance of some of these abnormalities is not clear at 

 present and many of them are probably of no clinical im- 

 portance. The adrenals rapidly undergo autolytic changes 

 after death and many of the histological pictures described 

 as characteristic of certain diseases are in reality post-mortem 

 changes. It would appear, however, that these post-mortem 

 changes are more prone to appear in individuals dying of 

 infectious or toxic processes for the observed abnormalities 

 are more striking in these subjects. 157 The gland subjected 

 to toxic influences apparently becomes subject to easier attack 

 by autolysis than the normal gland. Fissures are also often 

 noted between the medulla and cortex but it is questionable 

 if they are due to post-mortem changes or are the results of a 

 necrosis which has occurred during life. 175 



The pharmacodynamic effects of epinephrine have led 

 authors to assume that certain diseases of the vascular system 

 are resultants of abnormalities of the medulla, but there is 

 little to substantiate this clinical hypothesis. Except for the 

 rare cases of paroxysmal hypertension due to chromaphil cell 

 tumors, there is no disease which has been definitely shown to 

 be caused by hyper- or hypo- activity of the medulla or other 

 chromaphil tissues. 



Many diseases have from time to time been suggested as 

 associated with dysfunction of the adrenals. 230 Glaucoma, 



356 



