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J. J. MACKENZIE 



as some stain blue, others red and others shades of orange. Sometimes 

 blue and orange stain can he seen in the same droplet. They sometimes 

 have a close resemblance to the hyaline droplets seen in renal epithelium 

 in pathological conditions. Goldschmidt, from Oberndorfer's laboratory, 

 published a more detailed account of these granules and definitely con- 

 cluded that they are foi'med from phagocyted red cells, but from a study 

 of the granules with the Mallory stains we think this very improbable. In 

 the discussion of Oberndorfer's paper, Schmincke suggests that they are 

 morphological evidence of secretory activity and they undoubtedly could 



suggest this explanation. Kaw- 

 amura has described these drop- 

 lets also. He found them very 

 numerous in three cases of 

 typhoid but met with them in 

 other conditions although not 

 constantly. However, they are 

 not commonly present except in 

 acute infectious conditions. We 

 have noticed also that though 

 usually in the medulla, they are 

 not confined to it but may be 

 found in the cortex. Fig. 5 is 

 an oil immersion photograph of 

 a group of granules from the 

 medulla of a case of influenza 

 of six days' duration. Fig. 6 

 is a similar photograph from 

 the cortex of a case of general 

 peritonitis. 



In recent years the attention of pathologists has been specially turned 

 to the changes which occur in the constituents of the cortex and medulla 

 of the gland in cases of patients that have died as the result of acute 

 infections and intoxications and other pathological conditions. As a rule 

 attention has been focused upon either cortex or medulla and no special 

 attempt has been made to relate the one to the other. The most charac- 

 teristic change in the cortex is the more or less complete disappearance of 

 the cortical lipoid. Earlier writers, not understanding the significance of 

 the lipoid of the cortex, failed to note the variations, and even Neusser in 

 Iris monograph 011 the disease of the suprarenals, in Nothnagel's Encyclo- 

 pedia, pays little attention to it. Beginning with 1910, however, .more 

 and more attention was paid to the question and there has now accumulated 

 a considerable amount of literature upon the variation of the lipoid content 

 of the cortical cells. This variation has been determined most commonly 

 by applying to sections of the gland the ordinary fat stains, such as 



Fiji'. >. Oil immersion photograph of the 



medulla of the suprarenal of a case of epi- 

 demic influenza stained by Mallory's phospho- 

 tunjistic hematoxvlin. 



