OTHER PATHOLOGICAL ABNOKMALITIES 361 



bosis of the adrenal veins with death from acute adrenal in- 

 sufficiency has been reported. Such thrombi have been con- 

 sidered as due in most cases to an extension from smaller 

 thrombi formed in the capillaries of the cortex in acute in- 

 fections or other processes causing degeneration of the 

 parenchymal tissues. Thrombosis may also arise in the 

 adrenal veins as a result of conditions in the circulation. 

 Infarction of the adrenals results in a rapid destruction of the 

 medullary tissue. The cortical tissue is less apt to be ir- 

 reversibly damaged. 230 



The clinical symptoms attributed to extensive hemorrhage 

 in the adrenals are convulsions, vomiting, diarrhea, abdominal 

 pains, and hyperpyrexia. 230 As we have noted in previous 

 chapters, these symptoms may occur in experimental acute 

 adrenal insufficiency and it is thus not irrational to attribute 

 their occurrence in man to the same cause. An elevated 

 temperature is not uncommonly seen in animals for a day or 

 two following bilateral adrenalectomy (Chapter XIII). 



HYPERFUNCTION OF THE ADRENALS 



In considering hyperactivity of the adrenals we must differ- 

 entiate between the effects of hyperfunction of the three 

 elements of the gland 1) the medullary tissue, 2) the androgenic 

 tissue, and 3) the cortical or interrenal tissue. 



The only condition definitely associated with over-activity 

 of the medulla is the occurrence of paroxysmal hypertension in 

 cases of paraganglioma which we have described in Chapter 

 XXII. There is no valid evidence for Unking other diseases 

 of the circulatory, lymphatic, or endocrine systems with the 

 adrenal medulla. 



The results of overactivity of the androgenic zone have been 

 discussed in Chapter XXIII. 



No effects have been noted clinically which might be linked 

 with overactivity of the cortex proper. The hormone elab- 

 orated by this tissue is of a relatively small molecular weight 



