362 CLINICAL CONSIDERATIONS 



and is probably rapidly secreted or destroyed when introduced 

 in great excess into the organism. Over-dosages of this hor- 

 mone have also failed to demonstrate any changes in the 

 organism. Hence we might anticipate that physiological 

 hyperplasia of the adrenal cortical tissue with the production 

 of an abnormally great amount of its hormone would lead to no 

 pathological condition such as follows the elaboration of an 

 over-abundance of certain other endocrine products such as 

 insulin or the growth hormone of the pituitary. 



Hyperplasia of the adrenals, as noted in Chapter XXII, is 

 not infrequently found at autopsy. Such hypertrophy is 

 probably the result of an increased demand for the secretory 

 product of the cortex and can be induced in animals by sub- 

 jecting them for an extended period to any of the influences 

 (cold, heat, drugs, toxins, inanition, etc.) which cause an in- 

 crease in the rate of utilization of the cortical hormone. Al- 

 though it can not be denied that an actual overproduction of 

 the hormone beyond the needs of the organism occurs in 

 certain cases (as evidenced by adenomatous growths) no clinical 

 symptoms have been noted which might be attributed to this 

 cortical overactivity. 



HYPERTENSION 



The fact that epinephrine produces so marked a pressor 

 effect when injected has led authors from time to time to 

 ascribe the condition of essential hypertension to over-activity 

 of the adrenal medulla. Neusser 468 in 1898 first pointed out 

 the association of tumors of the adrenal gland with hypertension 

 and his theory as to the causal relation existing between these 

 two conditions has been revived periodically. Even within 

 recent years unilateral adrenalectomy has been performed for 

 the relief of essential hypertension. As has been indicated in 

 Chapter VI, there is no justification for assuming that hyper- 

 tension is in any way related to overactivity of the adrenal 

 medulla. Excision of a gland or cutting the splanchnic nerves 



