OTHER PATHOLOGICAL ABNORMALITIES 363 



is, therefore, to be deprecated in these conditions as a procedure 

 involving great hazard for the patient with no reason for assum- 

 ing that any therapeutic benefit will be derived. 



Aside from Neusser's findings, an association between hyper- 

 tension and hyperactivity of the adrenals has been claimed on 

 the basis of the frequency with which cortical adenomata and 

 hyperplasia are found in cases of hypertension. Thus Aubertin 

 and Ambard 24 in eight cases of hypertension found that four 

 showed a diffuse cortical hyperplasia, three had adenomata of 

 the cortex, and only one had normal adrenal glands. Hyper- 

 trophy of the cortical tissue is, however, a common finding at 

 autopsy and any observed hyperplasia is more apt to be sec- 

 ondary to rather than the primary cause of the hypertension. 



It has repeatedly been shown that there is no increase in the 

 epinephrine content of the blood in cases of hypertension. 639 

 The hyperglycemia observed in hypertension can not, there- 

 fore, be attributed to an assumed increased secretion of epi- 

 nephrine, but is probably due to a deficient pancreatic activity 

 resulting from arterio-sclerosis. 483 It is extremely difficult to 

 estimate the size of the medulla by simple examination at 

 autopsy. Attempts to arrive at an accurate estimate have 

 been made and would seem to indicate that there is some 

 hypertrophy of the medulla in patients dying of hypertensive 

 cardio-vascular-renal disease. These enlargements are, how- 

 ever, inconstant, and best explained as the result rather than 

 as the cause of the disease. 483 



HYPOFUNCTION OF THE ADRENALS 



There is no clear-cut evidence to associate hypofunction of 

 the adrenals with any clinical condition other than Addison's 

 disease. This disease, however, is the result of marked de- 

 struction of the adrenal cortex and it would seem most logical 

 to suppose that lesser degrees of injury or temporary conditions 

 which call for an excessive utilization of the hormone should 

 also result in deficiency symptoms of a minor degree. Un- 



