THE ADRENALS IN DISEASE AND POISONING. 37 



their normal size. The same phenomena followed injections 

 of bacillus pyocyaneus. Petit 70 , also found hypertrophy to fol- 

 low filtered cultures of the Loffler bacillus in fishes. That the 

 hypertrophic process is compensative is shown by the fact that 

 hypertrophy also occurs in the remaining gland when one has 

 been extirpated. Stilling 80 observed that in young rabbits the 

 remaining adrenal sometimes attained very large size; Auld 81 

 also reported several instances in cats. In the presence of 

 these facts it is evident that the adrenals are submitted to 

 excessive activity when toxics are introduced into the organism, 

 and that the local lesions are the expression of a physiological 

 function utilized beyond its normal limits. The histological 

 lesions found post-mortem are no longer pathological mani- 

 festations of the toxins introduced; they are those of overuse 

 and common to all. 



That we are dealing with the effects of overactivity is 

 sustained by evidence from another direction. In the instances 

 in which hypertrophy was caused by injections of toxins these 

 were administered in small doses at frequent intervals, the 

 process extending over a period of many weeks. If we analyze 

 Wybauw's report, there are points which tend to indicate even 

 more than the direct effects of toxins noted. This author 

 refers to promiscuously-distributed swollen cells, the proto- 

 plasm of which is less clear than usual, and to other features 

 that recall the characteristics of cloudy swelling observed most 

 frequently in the liver and kidney and in the heart-muscle. 

 This we know may be caused not only by bacterial toxins, but 

 also, and with equal frequency, by nutritional disturbances 

 excited by nervous stimulation. We have evidence that the 

 excessive stimulation of the nervous center of the organs must 

 underlie the overactivity induced, in the fact that electrical 

 stimulation of the splanchnic nerve causes, as we have seen, 

 an increase of suprarenal secretion. 



Of course, both processes local lesions induced directly 

 by the toxins and those brought on through excessive func- 

 tional activity may be simultaneously present in the organs. 



79 Petit: Loc. cit. 



80 Stilling: Virchow's Archiv, Dec., 1889. 



81 Auld: British Medical Journal, June 3, 1899. 



