FUNCTIONS OF THE SUPRARENAL CAPSULES. 481 



Nothing whatever is known of the lymphatics of the suprarenal capsules, and the 

 existence of these vessels, even, is doubtful. 



Chemical Reactions of the Suprarenal Capsules. A few years ago, M. Vulpian 

 discovered in the medullary portion of the suprarenal capsules a peculiar substance, 

 soluble in water and in alcohol, which gave a greenish reaction with the salts of iron and 

 a peculiar rose-tint on the addition of iodine. He could not determine the same reaction 

 with extracts from any other parts. Later, in conjunction with M. Cloez, he discovered 

 hippuric and taurocholic acid in the capsules of some of the herbivora. Other researches 

 have been made into the chemistry of these bodies, but without results of any great physi- 

 ological importance. 



State of our Knowledge concerning the Functions of the Suprarenal 



Capsules. 



In 1855, the late Dr. Addison, of Guy's Hospital, published a remarkable memoir upon 

 a peculiar disease which he had found connected with disorganization of the suprarenal 

 capsules. This disease, sometimes called Addison's disease, is characterized by bronzing 

 of the skin and is accompanied by serious disorders in nutrition. It was supposed to be 

 invariably fatal. The peculiar discoloration of the surface, attended with disorganization 

 of the suprarenal capsules, led physiologists to suppose that, perhaps, these bodies had 

 some function connected with the formation of pigment ; and, following the publication 

 of Dr. Addison's memoir, we find quite a number of experiments upon animals, consisting 

 chiefly in extirpation of the capsules. Before this time, there had been no reasonable 

 theory, even, of the probable function of these bodies. As our first ideas of the rela- 

 tions of the suprarenal capsules to the formation of pigment were derived from cases of 

 disease, it may not be out of place to consider briefly whether there be any invariable 

 and positive connection between structural change in these organs and the affection 

 known under the name of bronzed skin. 



In the memoir by Dr. Addison, are reported eleven cases of anaemia, accompanied 

 with bronzing of the skin, terminating fatally, and found, after death, to be attended 

 with extensive disorganization of the suprarenal capsules. The reports of these cases 

 attracted a great deal of attention among physiologists as well as pathologists. A year 

 later, Prof. I. E. Taylor, of Bellevue Hospital, reported seven cases of bronzed skin, in 

 two of which the diagnosis of disease of the suprarenal capsules was verified by post- 

 mortem examination. Attention now being directed to this peculiar condition of the 

 system, accompanied with discoloration of the skin, numerous cases were reported from 

 time to time, but some of them did not fully carry out the views of Dr. Addison. Per- 

 haps the most extensive collection of cases taken from a great number of authorities is 

 given by Dr. Greenhow, in his work upon Addison's disease. Dr. Greenhow is appar- 

 ently convinced that the connection between the constitutional symptoms and discolora- 

 tion of the skin, described by Addison, and disorganization of the suprarenal capsules is 

 well established. He reports one hundred and ninety-six cases ; and, out of these, he 

 selects one hundred and twenty-eight, as fair representatives of Addison's disease. There 

 are several cases (ten) in which-there was bronzing of the skin, the suprarenal capsules 

 being perfectly healthy ; but in only one of these were there any of the characteristic 

 constitutional symptoms. There are twenty-two cases cited of cancer of the suprarenal 

 capsules, not one of which presented the characteristic constitutional symptoms, only 

 seven presenting some slight discoloration Of the skin. Without discussing this subject 

 more fully, it seems justifiable to adopt the opinion, entertained by many pathologists, 

 that there is a connection between bronzed skin accompanied with certain grave consti- 

 tutional symptoms, and disorganization of the suprarenal capsules, which is frequent but 

 not invariable ; but it is not established that the destruction of the capsules stands in a 

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