138 THE DUCTLESS GLANDS 



The diagnosis must depend largely on the extraordinary 

 lack of resistance to fatigue, upon the other constitutional 

 symptoms, and upon the bronzing of the skin. Where this 

 last is absent the diagnosis must be difficult and uncertain. 



The prognosis is grave, but the patient may live a con- 

 siderable time, and care should be exercised in foretelling to 

 what extent life may be prolonged. At least one case is reported 

 where the symptoms of Addison's disease have completely 

 disappeared (Treckin). 



The treatment will be dealt with under the therapeutic 

 applications of adrenal substance (p. 204). 



8. Other Conditions involving Adrenal Insufficiency 



Defective development of the adrenals is not infrequently 

 associated with imperfect growth of the brain, particularly 

 in cases of anencephaly and hemicephaly. 



Total deficiency of the adrenal medulla has been reported. 

 Wiesel records a series of cases of what he calls " hypoplasia of 

 the chromaffin system." 



Lavenson, Sergent, and Cooke have described cases of 

 acute adrenal insufficiency, which may occur with symptoms 

 resembling an acute poisoning. These are apt to occur in 

 diphtheria, scarlet fever, typhoid fever, erysipelas, and 

 chloroform poisoning. Sergent connects certain conditions 

 which may supervene in typhoid fever with the syndrome of 

 adrenal insufficiency. 



French writers frequently refer to a condition due to adrenal 

 insufficiency, in which muscular weakness or lack of tone and a 

 low blood-pressure, along with digestive and nervous troubles 

 are striking symptoms. They have even attributed the 

 symptoms of " shell-shock " to adrenal insufficiency. 



9. Excessive Adrenal Function 



The fact that excessive production and pouring into the 

 circulation of the thyroid secretion appears to lead to a very 

 definite train of symptoms, has naturally suggested the 

 question whether an analogous condition of excessive pro- 

 duction of the adrenal secretion may be a factor of consideration 

 in the production of disease. 



The most striking effect of the adrenal secretion is a rise 

 of blood-pressure. As pointed out by Adami, hyperpiesis, or 



