o. BERNER. M.-N. Kl. 



There was a peculiarity, however, about this series which at once 

 made me uncertain. This was that the appearance of the proliferating zone 

 of the suprarenal gland remained quite unchanged throughout the series, 

 and this I thought it should not do if it were the point of issue of the 

 tumour. The most natural thing would probably have been for the tumour- 

 proliferation to have issued from one spot on the suprarenal gland, and 

 not from its entire periphery ; and this abnormality in the proliferation seemed 

 all the more striking from the fact that the interior of the left suprarenal 

 gland always proved to be quite normal. 



It was therefore natural that I should also wish to examine the right 

 suprarenal gland, but when I looked for it, it was not to be found. With 

 the greatest care I laid bare the top of the right kidney, and also examined 

 the back of the top, but found no suprarenal capsule. The entire surface 

 of the right kidney was smooth and shining as it should be, and the 

 colour all over was the fresh red that is seen in well-fixed specimens. 

 My wonder then was as to what could have become of this suprarenal 

 gland, and I turned my attention once more to the large tumour. It was 

 only then that I really noticed the large blood-vessel which had served as 

 its stem, and which I had to sever in order to remove the tumour from 

 the abdominal cavity. This vessel was the vena cava, and I now saw 

 how branches of it continued over the anterior surface of the right kidney 

 (fig. 8). I once more examined with great care the entire region sur- 

 rounding this stem to see whether I could find an}' suprarenal gland; but 

 there was none, and I was thus convinced that the large tumour, which I 

 had at first thought to be a large metastasis, was the right suprarenal 

 gland whence the tumour-proliferations had originated. The reason of the 

 similarity between the reticular appearance of the principal tumour and the 

 reticular appearance of the proliferating left suprarenal gland at once, too, 

 became clear: there was no longer any doubt in my mind that the pri- 

 mary tumour came from the right suprarenal gland, and that the tumour- 

 proliferation in the left was secondary to the former. 



In none of the numerous sections of the large tumour that I have 

 examined have I found any trace of the medullary substance of the supra- 

 renal gland, which, in birds, lies in cords imbedded in the cortical sub- 

 stance. In birds we find this structure of the suprarenal gland, which in 

 still lower vertebrate animals causes the medullary substance to collect in 

 the so-called "suprarenal organ", while the epithelial cortex becomes the 

 "interrenal organ", which lies between the kidney and the suprarenal 

 organ. 



In sections of the red, blood-infiltrated nodule seen in the photograph 

 straight above the vena cava, I found, in the periphery, some distinct eggs 

 of various sizes. These were surrounded by some rather lighter cells 

 resembling lutein-cells, but not nearly so typical as those I have shown 

 from the left ovary. 



