EFFECTS OP REMOVAL SIMILAR IN ALL VERTEBRATES. 7 



hours after onset of acute symptoms. Both capsules were en- 

 larged, and transformed into bags containing clots surrounded 

 by the cortex, which had thus been forcibly detached from the 

 medullary substance. 



CASE 5 (Garrod and Drysdale 19 ). Case, aged 4 months. 

 Brought into hospital dead. Both glands dark-purplish red, 

 though not enlarged; meshes of stroma filled with red corpus- 

 cles. 



CASE 6 (Droubaix 20 ). Case, 11 hours old at onset of symp- 

 toms. Death in 3 days. Hemorrhage into both organs, with 

 infiltration into the pericapsular cellular tissue. 



CASE 7 (Colman 21 ). Case, 11 months. Death in about 

 25 hours. Both capsules showed diffuse interstitial haemor- 

 rhage, and cultures proved sterile. 



Strongly suggestive, also, is the fact that, of the seventeen 

 cases of comparatively sudden death, fifteen showed suprarenal 

 apoplexy in both organs, while two only showed involvement of 

 but one organ. These two instances might invalidate the evi- 

 dence adduced, could the sudden death in them not be shown 

 to have been due to other causes. But such is the case: In 

 the one (Parrot's 22 case No. 11) the hemorrhagic adrenal had 

 ruptured, and the patient died of hemorrhage into the peri- 

 toneal cavity; in the other (Droubaix's 23 case No. 9) death 

 had resulted from uraemia, due mainly to granular and cystic 

 kidneys. 



Additional evidence is afforded by the fact that complete 

 destruction of but one adrenal proves harmless to man, as it 

 does in animals. The results of operative procedures insti- 

 tuted for the removal of suprarenal neoplasms prove this to 

 be the case. A liponiatous capsule, for instance, was removed, 

 along with a wedge-shaped piece of underlying kidney, by Mayo 

 Eobson 24 in 1897. "The wound healed by first intention and 

 the patient rapidly regained her lost flesh and strength. She 

 remains well, and had had no return of the trouble." This 



19 Garrod and Drysdale: Lancet, May 7, 1898. 



20 Droubaix: These de Paris, Case I, p. 26. 



21 Colman: Lancet, May 7, 1898. 



22 Parrot: Archives Generales de Medecine, vol. xcix, 1872. 



23 Droubaix: These de Paris, 1887 



* Mayo Robson: British Medical Journal, Oct. 21, 1899. 



