THE ADRENAL BODIES 139 



pronounced and continued rise of blood-pressure, is not an 

 uncommon condition. Roger and Gouget report hypertrophy 

 of the adrenals in a case of experimental arterio-sclerosis 

 induced by lead intoxication, while several authors have noted 

 a relation between arterio-sclerosis and hypertrophy of the 

 adrenal medulla. 



Three theories have been put forward to account for the 

 hyperplasia of the adrenal bodies in arterio-sclerosis : (1) The 

 hyperplasia is not the cause of the hypertension at all, but an 

 " antitoxic hyperplasia " due to the effects of the accumulated 

 products of metabolism which possibly also produce the 

 hypertension ; (2) the hyperplasia is the cause of the hyper- 

 tension, but is secondary to a renal lesion ; (3) the hyperplasia 

 is the cause of the hypertension, and is primary and independent 

 of the kidney mischief. 



It is yet too early to state which of these is the correct 

 view. The French writers insist that the adrenal hyperplasia is 

 almost constantly associated with chronic interstitial nephritis. 

 According to Pearce, it may equally be associated with chronic 

 parenchymatous nephritis. 



On the other hand, Mott states that in his experience in 

 advanced arterio-sclerosis the adrenal medulla is more often 

 atrophied than hypertrophied. 



Several writers have assumed a functional increase of the 

 chromaphil tissue in certain forms of diabetes mellitus. but 

 the matter cannot be regarded as definitely settled. The same 

 applies to the association of interstitial nephritis and hyper- 

 function of the chromaphil tissue. 



10. Adrenal Tumours 



Tumours of the adrenal body are perhaps most usually of 

 interest as bearing upon hyperf unction of the organ. But 

 since it is conceivable that in some cases the growths may 

 determine a reduction in activity, it is better to treat of them 

 in a separate section. 



A. Tumours of the Adrenal Medulla (Chromaphil Tissue). 

 A few cases of medullary glioma have been described. 

 Adenomata of the chromaphil tissue, or " paragangliomata " 

 are also mentioned. The symptoms noted were arterio- 

 sclerosis, and cardiac hypertrophy as well as disturbances of 

 nutrition, and other signs of a more general character. 



