CHAPTER VI. 

 SYNDROMES OF HYPERFUNCTION OF THE ADRENALS. 



A hyperactivity of the adrenals manifests itself clini- 

 cally by a cardio vascular syndrome characterized by 

 hypertension associated with a hypertrophy of the heart. 

 The rise is in both the systolic and diastolic pressure. It is 

 accompanied by a hypertrophy of the left ventricle which 

 is manifested by the pushing outwards and downwards 

 of the apex of the heart, a powerful shock against the tho- 

 racic walls, a marked aortic sound and a galloping sound 

 on the left side. The examination of the heart shows a 

 very marked hypertrophy (Widal and Raulot-Lapointe). 

 The various clinical manifestations of this cardio vascu- 

 lar syndrome will be studied in some other chapter. We 

 will only mention that clinically it appears in three 

 main forms. 



1. PURE FORM. The arterial hypertension constitutes 

 the only clinical manifestation, which is discovered acci- 

 dentally in plethoric subjects or young people with great 

 physical and mental activity. In other cases, the patients 

 are pale and emaciated and have symptoms of lassitude 

 and asthenia. 



The arterial hypertension is permanent and irreducible. 

 There are at certain times paroxysms caused by vas- 

 cular spasms at the level of various organs, in partic- 

 ular of the nervous system. Symptoms then manifest 

 themselves; such as, encephalitis, amaurosis, aplasia, 

 Jacksonian epilepsy, which are transitory and nearly 

 always influenced by hypotensive medication; they cease 

 with the spasm. 



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