The Pathological Anatomy and 



Histology of the Suprarenal 



Glands 



J. J. MACKENZIE 



TORONTO 



Introduction 



A proper conception of the pathological anatomy and histology of 

 the suprarenal glands is difficult at the present time, on account of the 

 lack of precise knowledge of their normal physiology. The discovery of 

 epinephrin, the ease with which it can be demonstrated in the suprarenal 

 medulla, in the other chromaphil tissues and in the blood, and the readiness 

 with which pure preparations can be used in experimental investigation, 

 has tended to give undue prominence to the epinephrin function of the 

 glands in contrast to the more bulky and possibly more important function 

 of the cortical portion. If we add to these difficulties the evident, but 

 as yet quite unravelled, relationships of the suprarenals to the other en- 

 docrin organs, a relationship which has been clouded in a mist of theories, 

 we see that the time has not yet come for final elucidation of suprarenal 

 pathology. 



In the past few years an enormous literature has grown up on the 

 subject of suprarenal insufficiency. But in the last analysis it is 

 questionable whether the great mass of it is worth the paper and ink 

 expended upon it. The isolation of epinephrin and the demonstration 

 of its pressor effect have been the grounds upon which has been built up a 

 mountain of theory. Suprarenal insufficiency, meaning usually by that 

 deficiency of epinephrin production, has been called in to explain not 

 only death in acute infections but even such conditions as surgical shock. 

 It was probably natural that this should be so, but it would be well if 

 physicians, and especially therapeutists, would wait until the physiology 

 of the suprarenal and the significance of the secretion of its medulla has 

 been elucidated as fully as possible before building up beautiful hy- 

 potheses in regard to the causation and treatment of disease. The work 

 of American physiologists in the past few years has done much to clear 



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