144 ENDOCRINE GLANDS 



the semi lunar ganglia of the greater sympathetic. For 

 many years Addison's disease was explained by means 

 of two theories. 



1. Glandular theory, based on the anatomical observa- 

 tions of Addison and the experimental researches of 

 Brown-Sequard, who reproduced the disease, less the 

 pigmentation, by removing the adrenals. 



2. The nervous theory advocated in France by 

 Jaccoud, Lancereaux and Brault. They believed the 

 disease was due to an alteration of the sympathetic. The 

 lesions of the gland stay latent until the filaments of the 

 abdominal sympathetic are affected. 



The investigations of Sergent and Bernard have estab- 

 lished the fact that Addison's disease is in reality a double 

 syndrome: slow insufficiency of the adrenals and irrita- 

 tion of the solar plexus or the sympathetic, the latter 

 explaining the pigmentation. The pigmentation is not of 

 hematic origin; it does not contain any iron. It is a 

 normal skin pigment and we know that the sympathetic 

 is the regulating nerve of the skin pigmentation. The 

 stimulation of this nerve causes a hypergenesis of the 

 pigmentary cells. The pigmentation does not always come 

 from the stimulation of the extra adrenal sympathetic 

 (solar and semi lunar ganglia). It may be the result of an 

 alteration of the ganglia and nerve in the adrenals, which 

 are so numerous in the medulla that the latter is considered 

 as a nerve layer in close relation with the adrenalogenous 

 cells (see physiology of the sympathetic). 



From these three main facts result : 



1. That melanodermia is the main symptom of the 

 disease described by Addison. "Without any melano- 

 dermia, there is no Addison's disease," says Sergent. 



2. Tuberculosis is the most frequent cause of Addison's 



