34 THE PHYSIOLOGY OF THE ADRENALS. 



through their nervous supply, and directly by invasion of 

 pathogenic elements of various kinds. 



What is the nature of the pathological process that follows 

 infection or the ingestion of poisons? The relation between 

 the class of cases previously described and this is well shown 

 by the reports of several observers, who not only refer to the 

 invariable presence of hyperaemia, but also to local haemorrhagic 

 processes. Rene Wybauw, for example, 70 injected diphtheria 

 toxin into the peritoneal cavity of a large number of guinea- 

 pigs, causing death within three days. In all these animals the 

 adrenals had become somewhat enlarged and showed intense 

 hyperaemia, the central vein being particularly engorged. In 

 one of them, a guinea-pig, the disease followed an acute course; 

 the vascular epithelium had yielded to the pressure and the 

 organs showed abundant haemorrhages. The reticular and 

 medullary zones, in which capillaries are especially abundant, 

 presented the most marked lesions. 



We have already seen that Abelous and Langlois also 

 found that the injection of various bacterial cultures caused 

 vascular lesions varying from slight congestion to severe haam- 

 orrhage. Two cases, reported by different observers, are par- 

 ticularly interesting in this connection: In the one, a case of 

 acute toxaemia reported by Andrewes, 71 death occurred in 36 

 hours, and the adrenals alone showed lesions interstitial haem- 

 orrhage. In the other, reported by W. S. Colman, 72 the symp- 

 toms also indicated a general infection; death occurred in 

 about 25 hours, and no lesion other than suprarenal inter- 

 stitial haemorrhage was found. The interesting feature of these 

 cases, however, is that both observers submitted blood taken 

 from the haemorrhagic foci in the organs to bacteriological 

 examination. Andrewes invariably obtained sterile cultures, 

 and he states that, if any organisms were present, "there were 

 none that grew upon ordinary media or stained with ordinary 

 reagents." Colman not only reached the same result with 

 blood from the adrenals proper, but with blood taken from 



70 Ren6 Wybauw: Annales de la Societe 1 Royale des Sciences M6d. et Nat. de 

 Bruxelles, vol. vi, p. 134, Nos. 2 and 3, 1897. 



71 Andrewes: Lancet, May 7, 1898. 



W. S. Colman: Lancet, May 7, 1898. 



