ADDISON'S DISEASE 305 



great measure to an empirical use of the extract, regardless of the dosage 

 indicated in each case. Schafer(a) has pointed out that the administration 

 of the gland extract cannot, as in the case of c&chexia* thyreopriva, take 

 the place of the internal secretion of the gland, and expresses the opinion 

 that until measures are found to induce grafts to take in man, Addison's 

 disease will probably continue to terminate fatally. Timme has recently 

 stated his belief that the terminal types of endocrin disturbances, such 

 as Addison's disease, are largely beyond the reach of glandular therapy. 



In only a few instances have attempts been made to replace the func- 

 tion of the diseased glands by the transplantation of healthy suprarenals 

 into the tissues of patients with Addison's disease, and in such cases the 

 results have been uniformly unsuccessful, and mainly disastrous. Bra 

 transplanted the suprarenals of a dog into the cellular tissue of the ab- 

 domen, in the case of a child with Addison's disease, but the operation was 

 followed by death in three days. Jaboulay reported two cases, with death 

 within twenty-four hours, following suprarenal transplantation. Cour- 

 mont, after a similar operation, described a "formidable hyperthermia,' 7 

 without infection of the wound, and a cardiac collapse, in his patient, 

 followed by death in twenty-four hours. As a result of his experience he 

 regarded this form of therapy clearly contraindicated in Addison's disease. 

 The results of animal experimentation have, moreover, proven a deterrent 

 towards such procedures in the human subject. Canalis, the first to at- 

 tempt suprarenal transplanting in animals, grafted small portions of the 

 gland into the kidney, but found that in every case except one, the 

 grafts became necrotic and were absorbed. Gourfein, Abelous, Boinet 

 and others have also reported unsuccessful results from grafts in various 

 parts of the body. Stilling(d), after grafting the suprarenals into the 

 testes, was able to find cortical tissue as late as three years following the 

 operation. One of the most successful attempts recorded is that of Busch, 

 Leonard and Wright, who were able to transplant the suprarenal of one 

 rabbit into the kidney of another, and to obtain positive evidence of func- 

 tioning graft survival, with a preservation of the medullary tissue of the 

 grafted gland. These authors believe the kidney to be the structure best 

 adapted for the reception of the grafts. With the progress of surgery 

 the hope of a successful form of substitution therapy in Addison's disease, 

 by suprarenal grafting, appears more rational than formerly. 



The reports in the literature, by competent observers, of the beneficial 

 results derived from suprarenal gland therapy have become sufficiently 

 frequent to merit consideration. The improvement recorded has been 

 mainly in the direction of diminishing the asthenia. Langlois(c), one of 

 the first to employ this form of treatment, believed that the myasthenia 

 could be markedly decreased, basing his view upon the ability of a pa- 

 tient, thus treated for a period of six weeks, to lift a weight 5-8 times 

 longer than before treatment, as demonstrated by ergographic tests. In 



