PATHOLOGICAL ANATOMY AND HISTOLOGY 261 



slightly larger than that of the fifth month but with a modeling like 

 the normal gland with a fully developed medulla. Weigert describes it 

 very well when he says, "Der Durchschnitt einer solchen Hemicephalenne- 

 benniere sieht ganz dem einer normalen ahnlich, nur dass alles gewisser- 

 aiaassen en miniature sich darstellt." 



Fig. 1 is a section of the suprarenal of an anencephalus fetus of 

 about the eighth month. It shows the typical folding of the fully de- 

 veloped gland. The medulla is beginning to show and the degeneration 

 of the fetal reticulata and fasciculata is well advanced, The right gland 

 measured 11 mm. x 13 mm. x 5 mm. in the formalin fixed specimen. 



The degree of this change 

 varies considerably in different 

 cases of anencephaly or hemi- 

 cephaly - and it still remains to 

 be shown what connection there 

 is between this more rapid de- 

 velopment of the gland and the 

 cerebral defect. Zander's critical 

 study of his large series with 

 various cranial defects lead him 

 to conclude that it was closely 

 correlated with failure to de- 

 velop of the anterior portion ef 

 the cerebral hemispheres. 



Dystopias of the gland may 

 involve the whole gland or sim- 

 ply the cortex. Eokitanaky was Fig 2 Focal necroses in the zona fasci . 



the first to describe the presence culata of a case of epidemic influenza. 



of the suprarenals beneath the 



capsule of the kidneys, Schmorl has described a right suprarenal beneath 

 the capsule of the liver. Other writers have found them embedded in kidney 

 tissue. Accessory masses of suprarenal cortex are commonly found beneath 

 the capsule of the kidney and between the renculi (Grawitz) although there 

 is still some doubt as to whether all the tumors described as hyperne- 

 phromata of the kidney are always suprarenal in origin. Besides occurring 

 in the kidney they are also found in the broad ligament (Marchand) and 

 the epididymis. Some aberrant masses may contain medulla but this is rare. 

 Pathological Chances in the Suprarenals as a Result of Infections 

 and Intoxications. Focal necroses are of common occurrence in the 

 suprarenal cortex. They occur most frequently in the zona fasciculata 

 and as Mallory has shown are similar to the focal necroses which occur in 

 the spleen and other organs as a result of acute bacterial toxemias. 

 Moschcowitz has described the condition also. Apparently regeneration 

 may occur, as Mallory figures active mitoses occurring in the cortical 



