14 o. BERNER. M.-N. Kl. 



case here described, sections were also shown by Professor Franxis Harbitz 

 from the tumour from Dr. CoUett's patient, and I was struck by the re- 

 semblance between the cell-forms in these two so widely-separated cases. 

 But that which seems to me to tell still more against the correctness of 

 Dr. Krabbe's theory is the similarity found between the tumour-proliferation 

 in the right and that in the left suprarenal in my hen. There can hardly 

 be any doubt that the tumour in the right suprarenal gland is primary, 

 and that it has secondaril}' caused the left suprarenal gland to proliferate. 

 This view of the circumstances accords with so many other observations, 

 such as, for instance, that a tumour is first seen to come in the one ovary, 

 and after a time an exactl}' corresponding one in the other, although the 

 second cannot be considered as due to metastasis. That the tumour-pro- 

 liferation is not of a metastatic nature as far as the left suprarenal is 

 concerned, is apparent from the fact that it is seen regularly throughout 

 a long series, and also because the interior of the suprarenal gland was 

 that of a quite normal organ. This very fact favours, I think, the view 

 that the left suprarenal gland had quite recendy entered upon a state of 

 proliferation, and the cause of this can hardly be sought elsewhere than 

 in the much older tumour in the right suprarenal. 



If this is the case, then the appearance of the proliferating epithelium- 

 cells in the periphery is also of ver}' great interest, for it will be seen 

 from the photograph reproduced in fig. 7 how the form of the cell changes, 

 and how. from the very first, the tumour acquires a most peculiar, reticu- 

 lated appearance; and this appearance of the tumour-proliferation is the 

 same in both suprarenal glands. Even if, therefore, the older suprarenal 

 tumour had developed upon the basis of absorbed cells such as Dr. Krabbe 

 indicates, the possibilit}' of such cells forming the starting-point of the 

 subsequent growth throughout the periphery of the left suprarenal is, I 

 think, in any case excluded. It seems to me, therefore, that there is no 

 necessity for having recourse to such an assumption as that of wliich 

 Dr. Krabbe makes use. 



In order to throw more light upon the question of the tumour's point 

 of origin, I have cut sections through that part where the blood-vessel 

 formed the stem which attached the tumour to the posterior abdominal 

 wall, but I have not found the appearance of the tumour in this region to 

 be different from that of the rest. It is therefore also out of the question 

 that the tumour originates in a possible persistent right parovarium. I 

 have also sought in vain for traces of medullary substance in the sections 

 of the tumour, so I consider that I am justified in my opinion that it is 

 cortical substance only — i. e. cells of the interrenal organ — that forms 

 the tumour. 



With regard to the peculiar reticular appearance oi' both the tumour 

 and the metastases in the ordinary sections, I have already pointed out 

 that it is due to the larere amount of fat contained in the tumour. The 



