114 FKANK A. HAKTMAN 



of the medulla was the most characteristic, short fissures surrounding 

 irregular fragments occurring in the protoplasm of the cell. The super- 

 ficial zone of the cerehral cortex was also vacuolated. The authors suggest 

 that these vacuoles are due to autointoxication. 



Donetti has also described changes in the central nervous system of 

 decapsulated guinea pigs and rabbits. In his animals also the bulb was 

 most affected. 



Congestion of the blood vessels has been described in death from cap- 

 sulectomy. Boinet(a) described thirty-five cases of pulmonary congestion 

 out of fifty autopsies on rats. There were two cases of hemorrhage. 

 Twenty cases showed congestion of the bulb. He was able to produce 

 congestion of the lungs and cerebrum with or without hemorrhage in rab- 

 bits, rats and guinea pigs by the injection of extracts of muscle, viscera or 

 blood taken from rats which had died of decapsulation. He attributed 

 this to toxic substances. 



Moore and Purinton(c) described cardiac thrombosis in three cats 

 which died of capsulectomy. Death had occurred within thirty-four hours 

 after the removal of the second gland. 



These post-mortem changes certainly point to the formation of toxic 

 products. 



Chronic Suprarenal Insufficiency 



We have given an account of symptoms produced in acute suprarenal 

 insufficiency. As we have pointed out before, some of them develop so 

 rapidly that they are difficult to follow. 



Attempts to r>roduce a chronic insufficiency are not new. Very many 

 have tried by different means to reduce the amount of suprarenal tissue 

 without destroying all. Nothnagel(a), Russo-Giliberti and Di Mattei and 

 others employed such methods as cauterization, crushing and injection of 

 substances into the gland. Some have sought to produce suprarenolysin 

 and epinephrmotoxin but they have added little to our knowledge of the 

 suprarenals further than the picture of the histological changes induced 

 by such procedure. 



Perhaps the most satisfactory method of destroying the function of 

 a large portion of the suprarenal is by reduction of the circulation. This 

 has been done by Martinotti in the rabbit, the suprarenal veins being 

 occluded. He studied the histological changes which followed. 



Alterations in the protoplasm and nuclei of both medullary and 

 cortical cells was observed as early as twenty-four hours after the occlusion. 

 The changes in the cortex varied considerably in different parts of the 

 gland apparently as a result of differences in circulatory modification. 

 The cells in some regions had become vacuolated and in many cases the 

 nuclei appeared shrunken. On the other hand, no characteristic changes 



