THE PATHOGENESIS OF BRONZING; ADDISON'S DISEASE. 85 



sies of cases of Addison's disease. In RispalV 8 case, notwith- 

 standing the presence of typical symptoms, including bronzing, 

 there was no evidence of tuberculosis, the abdominal sym- 

 pathetics were normal, and there was no evidence to show 

 that the adrenals had ever existed. He was only able to find 

 two similar instances in literature. In animals compensation 

 occurs in various ways. In four rats which survived bilateral 

 adrenalectomy several months Boinet found three or four red- 

 dish organs round the kidneys structurally similar to the cortex 

 of adrenals. He found the spleen enlarged and that its re- 

 moval rapidly caused death, thus strongly suggesting vicarious 

 function. Auld observed very great hypertrophy of the thy- 

 mus after one capsule had been removed two or three months. 

 In the human being accessory suprarenal bodies have been 

 found in the semilunar ganglion and in the midst of the solar 

 plexus by Jaboulay 19 and by Stilling. 20 Gottschalk 21 found 

 accessory adrenals in the infundibulo-pelvic ligament close to 

 one of the ovaries. Eossa, 22 in reporting a similar instance, 

 alluded to other well-authenticated cases. Wiesel 23 examined 

 fifteen pairs of testicles and epididymes from the newborn and 

 found accessory suprarenal capsules connected with them 23 

 times: 5 times on each side and 13 times singly. The accessory 

 organs had the same structure that the gland usually shows. 

 They were usually situated in the connective tissue about the 

 vas deferens, and were surrounded by a mass of blood-vessels. 

 In older children or adults no fully developed accessory glands 

 were found, but there were remnants in the form of strings 

 and clumps of cells. Aichel, 24 on the other hand, emphasizes 

 the importance of organs found by Marchand near the testes 

 in man and in the broad ligaments of woman, which organs 

 are homologous to the suprarenal bodies. These few examples 

 could be greatly multiplied were they not sufficient to show 

 that total absence, or complete, but slow, destruction of the 



'SRispal: Le Progres Medical, Aug. 29, 1896. 

 ^ Jaboulay: Lyon Medical, Nov. 2, 1890. 



20 Stilling: Revue de Medecine, Oct., 1891. 



21 Gottschalk: Centralblatt fur Gynakol., No. 15, 1898. 

 22 Rossa: Centralblatt fur Gynakol., No. 25, 1897. 



23 Wiesel: Wiener klin. Wochenschrift, May 5, 1898. 

 2 *Aichel: Munchener med. Wochenschrlft, Sept. 4, 1900. 



