138 INTERNAL SECRETION 



of the suprarenal function, was followed by a large number of 

 experiments, undertaken with the object of discovering whether or 

 not the suprarenals are essential to the life of the organism. The 

 lack of a sound anatomical basis was, however, a great bar to 

 physiological investigation. It was not until after nearly fifty 

 years of experimental work of the most searching kind, that the 

 conflicting evidence was reconciled and a satisfactory solution of 

 the problem finally discovered. 



A brief review of the evolution of the subject is not without 

 interest. 



As the result of his experiments with animals, Brown-Sequard 

 came to the conclusion that the removal of both suprarenals, or 

 even of one, as he originally believed, resulted in death within a 

 very short time (average 34 hours), and that death in such cases 

 was due to suppression of the suprarenal function. It was not 

 long, however, before this view was disputed upon many sides. 



It was pointed out. by Gratiolet, Philipeaux, Berrutti and 

 Perusino, and Harley that the death of the subjects might easily 

 result from secondary affections, such as surgical shock ; the lesion 

 of numerous nerves and plexuses, the semilunar ganglion 

 more particularly; hepatitis and peritonitis. But more impor- 

 tant than this was the fact that numerous accounts were given by 

 different authors (Martin-Magron, Berrutti and Perusino, 

 Philipeaux, Harley, Chatelain, Schiff) of cases where animals, as 

 mice, rabbits, cats, dogs, horses, and especially rats, lived with- 

 out pathological signs for weeks and months after extirpation of* 

 both suprarenals. 



With this negative solution of the problem of the vital im- 

 portance of the suprarenals, general interest in the subject 

 declined, and to such an extent that between 1863 and 1879 no 

 publication dealing with the experimental side appeared. 



Nothnagel's experiments in 1879 supplied a fresh stimulus 

 to investigation. He, together with other scientists both of his 

 own and of a somewhat later day (Foa, Burg, Russo-Giliberti 

 and Di Mattei, Tizzoni, Alezais and Arnaud), endeavoured 

 by means of lesions of the most varied description (crushing, 

 cauterization, &c.) to produce chronic inflammatory processes of 

 the suprarenals, in the hope of obtaining experimentally the 

 clinical complex of Addison's disease, as seen in man. These 

 experiments were of little value in determining the vital import- 

 ance of the suprarenals, for, in the large majority of cases, there 

 is no proof that by the methods employed the whole of the supra- 

 renal tissue was removed. It is 'much more probable, and the 

 experimental evidence points directly to it, that where the animals 

 lived for some time after operation, portions of suprarenal tissue 

 had been left in situ, and that, as a result of regenerative pro- 

 cesses, these remnants became enlarged later. This accounts also 

 for the statement that animals will live for some time after sup- 



