THE SYMPATHETIC SYSTEM 157 



2. FORMS ASSOCIATED WITH CHRONIC NEPHRITIS. 

 With the arterial hypertension is noticed signs of arterio 

 sclerosis and atheromata: dilatation of the aorta, systolic 

 or diastolic murmur of aortic insufficiency. 



The evolution of these various syndromes is variable. 

 Some patients die of vascular hemorrhages (cerebral 

 hemorrhages, epitaxis, hemorrhages of the mucosa) . Some 

 die of renal complications or of uremia. Others finally 

 die from symptoms of failure or cardiac insufficiency. 

 Two complications are particularly important. 



(a) Acute edema of the lungs, in patients with renal or 

 aortic lesions. 



(6) Glycosuria, which is usually transitory and mild. 1 



The two most important causes of these syndromes of 

 adrenal hyperf unction are: 



1. NEPHRITIS. Be it some infectious nephritis or a 

 chronic nephritis. 



2. MERCURY POISONING. These cases nearly always 

 show a plain hypertension or associated with either signs 

 of nephritis or arteriosclerosis. 



* * 



The understanding that adrenal hyperfunction can be 

 responsible for chronic affections; such as, hypertension, 

 cardiac hypertrophy, vascular lesions (atheroma and 

 arterio sclerosis) and also temporary affections; such as, 

 acute edema of the lung and glycosuria is proved by two 

 different kinds of facts. 



1. ANATOMICAL FINDINGS. Manetrier, Vaquez, Auber- 

 tin, Gaillard, Widal, Boidon and Josue have shown at 

 autopsies of patients having atheromatous or nephritic 

 lesions with cardiac hypertrophy, some cases with adrenal 



1 Test for adrenal hyperirritability: Subcutaneous injection of 1-1000 adrenalin. 

 Thirty minutes after injection there will be a rise in blood sugar. 



