6 THE PHYSIOLOGY OF THE ADRENALS. 



details furnished are at least sufficient to enable us to obtain 

 what appears to be strong evidence to the effect that, precisely 

 as it does in the lower animals, destruction of the adrenals in 

 man causes death within a very brief period. 



Indeed, out of the eighty cases collected by this investiga- 

 tor, death occurred within a period ranging from a few hours 

 to three days in fifteen. In all of these the pathological data 

 given show that both glands had been the seat of the hemor- 

 rhagic process: of "suprarenal apoplexy," as he terms it. Ten 

 of these cases, however, lose some of their value as testimony 

 because no allusion is made to the condition of the other or- 

 gans. In the other five, including details that we have obtained 

 from the original reports, it is specifically stated that lesions 

 were found nowhere else in the organism. To the following tabu- 

 lated list of these cases we have added two recently reported 

 (Andrewes and Colman): 



CASE 1 (Arnaud 15 ). Male, 36 years. Death occurred 48 

 hours after entrance. Both glands were apoplectic and greatly 

 enlarged. One weighed 28 1 / 2 grammes; the other 48 grammes. 

 Both when cut resembled flesh, and were studded with hem- 

 orrhagic foci and spots of haematomatous organization indi- 

 cating a progressive lesion of long standing. A small amount 

 of medullary substance was still present in the right capsule, 

 but otherwise the organs were structurally destroyed. 



CASE 2 (Arnaud 16 ). Female, 17 years. Death occurred 

 suddenly on the eleventh day after the receipt of a burn on 

 the arm; the symptoms suggested acute poisoning, but the 

 autopsy revealed hemorrhage into the right capsule and con- 

 gestion of the left. 



CASE 3 (Andrewes 17 ). Female, 15 months. Death 36 

 hours after onset of symptoms. Both capsules showed inter- 

 stitial hemorrhage. All cultures were sterile, or, if any or- 

 ganisms were present, not one grew on ordinary media or 

 stained with ordinary reagents. 



CASE 4 (Mattei 18 ). Male, aged 60 years. Death in 24 



16 Arnaud: Archives Generates de M6decine, pp. 16 and 53, July, 1900. 

 18 Arnaud: Archives Gn6rales de Mgdecine, p. 50, July, 1900. 



17 Andrewes: Lancet, May 7, 1898. 



18 Mattei: Lo Sperimentale, 1863. Case I in Trans. Gaz. hebdom Paris 

 No. 35, p. 380. 



