OTHER PATHOLOGICAL ABNORMALITIES 359 



cause collapse and death from cortical insufficiency. Further 

 studies are needed, however, to substantiate these assumptions 

 as to the role of the adrenal in these conditions. 



OTHER ANOMALIES 



Defects of the adrenal have been reported in other develop- 

 mental anomalies but it is questionable if any very important 

 significance can be attributed to these findings. Thus in 

 Schridde's disease in which edema of the newborn is accom- 

 panied by maldevelopment of the erythropoietic system, 

 Yasukawa 694 noted fatty infiltration of the innermost layers 

 of the cortex. This slight anomaly certainly appears to merit 

 no great attention. 



There is also a reduction in the lipid content of the adrenals 

 and hypoplasia of the adrenals and thymus in exfoliation of the 

 skin of the newborn (Ritter's disease). These associations 

 too are of doubtful significance. 230 



Reports of absence of the adrenals reported by earlier 

 workers 140 are now generally discounted. As we have seen 

 (Chapter XXI), in Addison's disease due to atrophy, the 

 remnant of adrenal tissue may be so small as to escape notice 

 unless carefully sought. The reports of absence of one adrenal 

 may be accepted as due to destruction by unilateral atrophy. 

 The congenital absence of one gland has been reported in a 

 patient in whom some of the other abdominal viscera on the 

 same side were also absent and in whom a number of other 

 congenital anomalies were found. 417 The adrenal has been 

 described as malformed by an unnaturally projected fissure 

 through the entire gland at the hilum. In some cases the 

 gland on one side is doubled or the chromaphil tissue has failed 

 to occupy its normal position within the cortex but occupies a 

 position on the surface of the gland 157 as in the reptilian adrenal. 



HEMORRHAGE AND OTHER VASCULAR LESIONS 



The adrenals are sometimes the site of hemorrhages which if 

 extensive may induce adrenal insufficiency. 572 Massive bi- 



