ADDISON'S DISEASE 283 



ease was that any lesion of the suprarenal glands, sufficient in degree 

 to interfere with their function, would give rise to the train of symptoms, 

 in effect, a theory of glandular inadequacy. This view of Addison's was 

 quickly subjected to much criticism by his contemporaries, Wilks and 

 Greenhow, by reason of the fact that further pathological observations 

 revealed examples of the disease, with clinical symptoms present, in which 

 at autopsy no apparent disease of the suprarenal glands was demonstrable, 

 and of other cases with advanced destructive lesions of the glands, in 

 which the clinical symptoms of the disease had been wanting. Such 

 conflicting observations led these authors to regard the genuine Morbus 

 Addisonii as originating from a special lesion of the glands, and to main- 

 tain that no other lesion would give rise to the disease. According to their 

 view, while the lesion in the suprarenal glands was special and primary, 

 the clinical symptoms were produced by the secondary effects of the lesion 

 on the neighboring sympathetic nerves, the semilunar ganglia, and the 

 solar plexus. Addison, as well, somewhat altered his earlier theory, and 

 was inclined to regard an involvement of the sympathetic system as a 

 possible contributing factor in the causation of, the disease. The finding 

 of alterations in the sympathetic system gave rise to the so-called nervous 

 theory of the origin of the disease, an hypothesis which found general 

 favor in the early history of the disease. This theory appeared the more 

 attractive by reason of the fact that the suprarenal glands, morphologically, 

 were at that time commonly regarded as forming an essential part of 'the 

 sympathetic system, the medulla being described as consisting almost 

 exclusively of ganglion cells. Modifications of this theory were offered 

 by Alezais and Arnaud and by Jaccoud. As pathological observations 

 on the disease became extended, skepticism arose concerning the validity 

 of this theory. It was found that in certain outspoken cases, no lesions 

 in the sympathetic system could be discovered, and conversely that in some 

 cases, which at autopsy showed irritation of the sympathetic ganglia, no 

 clinical symptoms had been manifest. 



Gradually the true glandular character of the suprarenal bodies was 

 revealed, as a result of anatomical and physiological research^ and with 

 this knowledge the glandular theory of the disease became established. 

 Brown-Sequard(a) in the year following Addiscn's communication, made 

 the important observation that extirpation of both suprarenal glands in 

 animals was invariably followed by death within one or two days, with 

 symptoms of general weakne'ss, convulsions, delirium and coma. He 

 further noted that after the removal of both glands, life might be pro- 

 longed by the injection of the blood of healthy animals, and also that the 

 death of an animal, from which one gland had been removed, could be 

 hastened by the injection of the blood of animals, deprived of their glands. 

 As a result of his investigations he concluded that the suprarenal glands 

 are absolutely essential to life, and that the blood of animals, from which 



