148 INTERNAL SECRETION 



that the loosening of the ligatures was followed, in from ten to 

 thirty minutes, in three out of eight cases, by a distinct rise in 

 blood-pressure. 



The results of Strehl and Weiss's experiment, though in- 

 teresting, have in my opinion been very much overrated. The 

 experiment really only shows that the specific substance elaborated 

 by the suprarenal is perpetually conveyed into the blood-stream 

 by the blood from the suprarenals. If, after complete extirpation 

 of the suprarenals, death is due to the absence of this substance, 

 or rather to the reduction in blood-pressure caused by its absence, 

 we should expect the operation to be immediately followed by 

 a somatic sinking of the animal, accompanied by a continued 

 fall in blood-pressure. The fall in blood-pressure described by 

 Strehl and Weiss was, however, only transient, the authors 

 describing it as lasting several seconds. Lewandowski found 

 that thirty minutes after extirpation of both suprarenals -the 

 blood-pressure was normal. 



I myself found that, after removal of the suprarenals from 

 the extraperitoneal situation in which I had placed them, there 

 was a fall in blood-pressure lasting fifteen to thirty minutes, 

 except in cases when the animal was much affected by the opera- 

 tion and the anaesthetic. At the end of that time the blood- 

 pressure gradually rose and, by the next day, had reached the 

 normal. Where the anaesthesia is more profound and the supra- 

 renals are removed by laparotomy, the blood-pressure becomes 

 very much reduced and in some instances there is no recovery. 

 As a general rule, however, where the method of operation is 

 technically above reproach, animals from which both supra- 

 renals have been removed usually appear to be perfectly well, 

 with normal blood-pressure for two< or three days, after which 

 they die (Hultgren and Andersson). This applies more particu- 

 larly to cases where the suprarenals have previously been dis- 

 lodged, the ultimate removal taking place extraperitoneally. A 

 few hours before death there is a distinct gradually increasing 

 fall in blood-pressure, though the same phenomenon is observed 

 in all moribund animals. As neither ligature of the veins nor 

 removal of the suprarenals is followed by an appreciable decrease 

 in blood-pressure, there is no actual proof that death is due 

 solely to the suppression of the agent which stimulates blood- 

 pressure. The cause of death after complete extirpation of the 

 suprarenals is, at present, unknown. 



The assumption that death after total suprarenal extirpation 

 may, in some measure, be due to intervention of the cortical 

 portion or, in other words, that the interrenal tissue is 

 essential to life is justified upon various grounds. 



It has been repeatedly proved that the accessory organs 

 which, after removal of the suprarenals, suffice to maintain life, 

 are entirely composed of cortical tissue, or, in the terminology 



