140 THE DUCTLESS GLANDS 



Malignant medullary hypernephromata also occur, and, 

 although the chief interest of these cases depends on the 

 distribution of the secondary growths, yet it will be advisable 

 to give a short account of their most striking features. The 

 syndrome associated with these growths was first described 

 by Hutchison. Most of the cases occur in children two or 

 three years old, and in many the earliest characteristic sign is 

 a hsemorrhagic streak upon one or both upper eyelids. This 

 is followed by exophthalmos and optic neuritis. The disease 

 is always fatal, usually within six months. The primary 

 tumour is believed to arise from the chromaphil tissue of the 

 medulla of the gland, and consists of round or oval cells with 

 large nuclei and a granular protoplasm. It is doubtful whether 

 it is a sarcoma or a carcinoma. 



B. Tumours of the Adrenal Cortex. These may be divided 

 into two groups. In the first are included the sarcomata, 

 carcinomata, endotheliomata, and cysts. These for the most 

 part only give rise to general results such as may be expected 

 from benign or malignant tumours. In the second group are 

 included the adenomata and hypernephromata. The clinical 

 importance of these will be discussed later in connection with 

 the relations of the adrenal cortex to the genital functions 

 (p. 241). 



E. Extirpation Experiments in Mammals 



The earliest extirpations of the adrenals were performed by 

 Brown-Sequard in 1856. He employed for extirpation of both 

 glands forty -four rabbits, nine guinea-pigs, two rats, and several 

 dogs and cats. All these animals died in nine to thirty -seven 

 hours after the operation. For the unilateral operation this 

 experimenter used sixteen rabbits, five guinea-pigs, two cats, 

 and two dogs. All these died in twenty-three to thirty-four 

 hours. Later he reported that two dogs survived removal of 

 one gland for eight days. As a rule young animals survived the 

 operation longer than adults. Brown-Sequard came to the 

 conclusion that the death after adrenal extirpation was not due 

 to adventitious lesions connected with the operation, but to a 

 cessation of the function of the glands. He noted marked 

 nni-riilar weakness, but not vomiting or pigmentation, and he 

 supposed that the absence of these two last symptoms is due to 

 tin- rapidity with which a fatal iv>ult supervenes. 





