138 ENDOCRINE GLANDS 



pallor of the face, vomiting, abdominal pain, cardiac dis- 

 turbances : tachycardia, ary thmia, inequality of the pulse 

 and end with sudden death. There is extreme hypo- 

 tension and the white line is quite marked. The experi- 

 mental observations of Oppenheim and Loeper and the 

 clinical data of Martin and Darre, of Hutinel and others 

 have proved quite conclusively the adrenal pathogenesis 

 of the late accidents following diphtheria. 



(6) TYPHOID FEVER. Sergent and Castaigne have 

 shown that certain phenomena observed in the course of 

 typhoid fever and characterized by asthenia, feeble cardiac 

 contractions, soft and weak pulse, drop in blood pressure, 

 which usually are considered as symptoms of myocarditis 

 are really symptoms of adrenal insufficiency. They are, 

 furthermore, better improved by suprarenalin than by 

 cardiac tonics. Sudden death during convalescence con- 

 sidered by some to be due to myocarditis and by others to 

 be a cardiac reflex, of intestinal origin, can be the result of 

 adrenal insufficiency. 



(c) SCARLET FEVER. Hutinel has insisted on the 

 adrenal pathogenesis in the severe syndrome of scarlet 

 fever. It is also to this adrenal insufficiency that we have 

 to place the blame of sudden death in this disease (Moizart 

 Gouget and Dechaux). 



(d) Adrenal insufficiency can complicate all the infec- 

 tious diseases: pneumonia and broncho pneumonia, 

 influenza, measles, erysipelas (Lesne), cholera (Naame), 

 dengue (Koury), certain symptoms of pernicious malaria 

 (Paisseau and Lemaire), various septicemias. The severe 

 erythemata, which occur in the course of infectious 

 diseases, often are indicative of an acute inflammation of 

 the adrenals (Ribadeau-Dumas and Harvier). 



The acute infections determine an adrenal insufficiency 

 by causing massive lesions of the adrenals. If the 





