102 FRANK A. HARTMAN 



A number of workers immediately questioned suprarenal insuffi- 

 ciency as the cause of death. Gratiolet found that removal of the 

 right gland only (guinea-pig) produced the same symptoms as the re>- 

 moval of both glands. Because of the hepatitis and peritonitis which 

 he observed in his animals he came to the conclusion that the loss of the 

 gland was not the primary cause but rather it was the injury to the liver 

 and other structures which was responsible for the symptomatology ob- 

 served. 



Philipeaux in the same volume of the Comptes rendus de r Academic 

 des Sciences in which the foregoing observations were published concluded 

 as a result of extirpation experiments with the rat that the suprarenals 

 are not essential to life. Although removal of both glands at the same 

 operation caused death in one or two days, no ill effects were produced 

 in some animals if each gland was removed at a different time with sev- 

 eral days intervening. The glands were removed by the lumbar route. 

 Many others working with different animals came to similar conclusions. 



After several years, during which no work was done toward a solu- 

 tion of this problem, ^othnagel(a) revived interest by trying to produce a 

 true Addison's disease through lesions of the glands. He hoped to in- 

 duce a chronic inflammation. At this time, however, no work was done to 

 settle the important question as to whether the suprarenals are vital to life. 



In 1891-92 Abelous and Langlois(a) (b) (c) clearly demonstrated the 

 vital importance of the suprarenals. Removal of one gland was without 

 effect while destruction of both caused death in two or three days in the 

 frog and in less time in the case of the guinea pig. They observed that 

 death was preceded by muscular paralysis and slow respiration. 



Among the numerous investigators studying the problem during this 

 period were Hultgren and Aiidersson(a) whose careful work deserves' spe- 

 cial notice. They found in cats that one-sided extirpation did not produce 

 death and that the removal of both glands in two stages prolonged the 

 life of the animal to an average of 130 hours in cats (11 cases), whereas 

 when both were removed at one operation the average length of life was 

 G8 hours. Rabbits might live as long as five or six days after removal 

 of both suprarenals. Animals, previously castrated, survived double cap- 

 sulectomy many hours longer than those not castrated, in some cases twice 

 as long. 



In recounting the steps which established the importance of the supra- 

 renals we must include the extensive researches of Strehl and Weiss. 

 They operated upon more than one hundred animals, the capsules being 

 reached in most instances through an incision along the linea alba. In 

 a few cases, however, the approach was made through the lumbar path- 

 way. The time of survival after double capsulectomy was compared in 

 several different species. Guinea pigs lived four to nine hours after re- 

 moval of the glands while dogs sometimes survived as long as one hun- 



