THE SYMPATHETIC SYSTEM 159 



injection of suprarenalin causes the appearance of sugar 

 in the urine of certain animals (Blum). 



(e) Adrenal hyperplasia can be caused experimentally 

 by toxic substances, in particular, by lead (Bernard and 

 Bigart). Lead causes at the same time atheromatous 

 lesions and hyperactivity of the adrenals (Gouget). On 

 the other hand, Dopter and Gouraud, then Darre, have 

 shown the frequency of adrenal hypoplasia during the 

 course of uremia or experimental nephritis. Schu and 

 Wiesl are said to have found it present in the serum 

 of animals having nephritis with hypertension. 



The relationship between hyperplasia of the adrenals 

 and its clinical consequences : hypertrophy of the heart, 

 hypertension, and vascular lesions, has given rise to 

 several interpretations. 



1. THE HYPERPLASIA OF THE ADRENALS is PRI- 

 MARY. Certain intoxications, certain infections (lues, 

 malaria), certain types of nephritis also cause a hyper- 

 plasia of the adrenals followed by arterial hypertension, 

 cardiac hypertrophy and arterio sclerosis. 



2. THE ARTERIO SCLEROSIS is PRIMARY AND THE 

 ADRENAL HYPERPLASIA SECONDARY. Arterio sclerosis 

 is not always of adrenal origin. It may be infectious or 

 toxic, or secondary to some kidney lesion. Adrenal 

 hyperplasia then occurs to keep up the cardio arterial 

 tonus, which must be raised to overcome the vascular 

 lesions, according to the mechanism indicated by Gouget. 



3. ADRENAL HYPERPLASIA CAN BE SECONDARY TO 

 CARDIAC LESIONS. ACCOMPANIED BY HYPERTROPHY 

 OF THE HEART. According to Josue, primary cardiac 

 hypertrophy exaggerates the myotonic function and 

 causes, by a sort of physiological adaptation, an adrenal 



