THE ADRENALS IN DISEASE AND POISONING. 35 



other organs. The cases had doubtless been caused by a spe- 

 cific toxin, but with the ever-present hypersemia as a terminal 

 feature. 



Does a specific organism or its toxin produce its own char- 

 acteristic lesion in the adrenals? Wybauw 73 states that he has 

 invariably found in these organs, after the injection of diph- 

 theric toxins in rabbits, the histological lesions found else- 

 where in this disease. He further noted that the point of 

 union of the reticular and medullary zones, where the capil- 

 laries are especially numerous, presented the well-known type 

 of degeneration, while the slides also clearly showed all the 

 stages of cellular destruction, with more or less disintegration 

 of the nuclei. The latter were also undergoing retrogressive 

 stages, gradual loss of regular outline., irregular perimetric 

 retraction, etc. He likewise examined microscopically the ad- 

 renals of a guinea-pig killed with cholera germs, but in this 

 connection he says: "The adrenals are the seat of much less 

 pronounced changes than those of the diphtheric guinea-pig. 

 They are redder than normal. But the examination shows 

 lesions which must certainly le produced by the same mechanism. 

 The cells are irregular, the nucleus having lost in places its 

 characteristic structure," etc. In a case of broncho-pneumonia 

 following tracheotomy for diphtheria, he was able to .note the 

 same changes that he had observed in the diphtheric rabbits 

 and choleraic guinea-pigs, but less marked, the patient having 

 died of the concomitant disease before the diphtheric process 

 had become far advanced. Arnaud, 74 in a case of suprarenal 

 hemorrhage associated with liver-abscess, also found lesions in 

 the suprarenal medulla characterized by cellular degeneration, 

 granular disintegration, etc.: i.e., a general necrobiosis of sep- 

 tic origin. If to these results we add those of Andrewes and 

 Colman, referred to above, it seems clear that we can, with 

 Wybauw, conclude that bacterial toxins as a class possess a 

 direct destructive action upon adrenal tissue. 



But this observer ascribes to the adrenals a special sen- 

 sitiveness to the influence of diphtheric toxins. While this may 

 be the case, it seems to us that, inasmuch as a specific toxin 



73 Wybauw: Loc. cit., pp. 134 and 165. 

 '* Arnaud: Loc. cit., p. 15. 



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