488 METABOLISM, NUTRITION, AND DIET 



derangement of calcium metabolism suggests the thought that the symptoms 

 might be relieved by supplying this substance. The matter is presented 

 in the following words of Berkeley and Beebe: "Probably the most striking 

 argument in favor of Macallum's theory in respect to tetany parathyreo- 

 privus is that it may be relieved almost instantly by the intravenous injec- 

 tion of a soluble calcium salt. We have repeated the experiment and find 

 that intravenous injections of a soluble calcium salt will relieve tetany almost 

 instantly; intramuscular injections may be effective after a period of thirty 

 to forty-five minutes, and a similar period is required for the beneficial 

 effect after subcutaneous injection. The effect of the calcium salt when given 

 intravenously to an animal in advanced states of acute tetany is one of 

 the most striking in the range of physiological experimentation." 



Koch in 1913 studied the metabolism of dogs after parathyroidectomy, 

 using physiological chemical methods, supplemented by histological examina- 

 tion. The urine of these dogs contained the toxic substances methylguanidine 

 and other guanidine bases in large quantities. These are purin compounds. 

 The examination of the tissues showed extensive chromatolysis, degenerating 

 epithelial cells in the intestinal tract, and nuclear disintegration in the liver 

 and especially the kidney. These led him to the view that the absence of 

 the parathyroids resulted in disturbance of nuclear metabolism, a " nuclear 

 atrophy." It has already been shown that nucleoproteins are richly present 

 in the parathyroids and their extracts. Injections of nucleoproteins freshly 

 prepared also relieve the symptoms of acute tetany in dogs. Berkeley 

 and Beebe state: "We believe that the essential fact in the production of 

 symptoms following complete thyroparathyroidectomy is the deranged 

 metabolism giving rise to some active poison, and not the abnormal excretion 

 of calcium which we regard as an accompanying phenomenon, perhaps due 

 in part to the starvation cachexia which ensues in most cases if the animal 

 is tided over the acute condition." This view, it will be noted, was borne out 

 by the later work of Koch. 



The Suprarenal Capsules or Adrenals. These are two flattened, 

 more or less triangular or cocked-hat shaped glandular bodies, resting by 

 their lower border upon the upper border of the kidneys. 



The gland tissue proper consists of an outside firmer cortical portion, 

 and an inside soft dark medullary portion, figure 315. 



The adrenals are very abundantly supplied with nerves, chiefly com- 

 posed of non-medullated fibers. These fibers are derived from the solar 

 and renal plexuses and the vagi, but the method of their termination is 

 unknown. 



A vast amount of information has been given concerning the function 

 of the suprarenal capsules within the last few years by the researches of 

 Oliver and Schafer, Zyboulski, Abel, Aldrich, Dakin, Dale, Elliot, Cannon, 

 and others. Brown-Sequard, it is true, showed by experiment as early 



