154 INTERNAL SECRETION 



Let us take these symptoms singly and examine them more 

 closely. 



The initial symptom, a reduction of 2-4 in temperature 

 immediately after operation, has very little clinical significance. 



This fall in temperature is quite transient, the figure becom- 

 ing again normal twenty-four hours after operation. Personally, 

 I have never observed the initial fall in animals operated upon 

 by my method. In cases, however, where the results of operation 

 are complicated by haemorrhage, prolonged narcosis, &c., the 

 initial fall in temperature may be continued and progressive. As 

 a general rule the temperature begins to drop forty-eight hours 

 before death, after the asthenic symptoms have appeared. From 

 then onwards the reduction is progressive. The normal rectal 

 temperature of 39 C. drops to 34 C., and immediately before 

 death to 30 C. and under. Hultgren and Andersson regarded 

 this abrupt fall in the temperature curve before death as charac- 

 teristic of animals from which the suprarenals had been removed. 



The emaciation which follows removal of the suprarenals may, 

 with greater justification, be regarded as characteristic of the con- 

 dition. There is a considerable reduction in weight immediately 

 after operation, and thus reduction is slowly progressive. The 

 loss is undoubtedly partly due to the lack of appetite, the animal 

 in the later stages refusing all food. That a relationship exists 

 between the emaciation and the suppression of the suprarenal 

 function is proved by the fact that the removal of the suprarenal 

 from one side only is followed by a considerable loss of weight. 

 This lasts from two to three weeks, when an increase in weight 

 takes place. It is an interesting fact that intestinal derangements 

 and diarrhoea are not usually associated with the condition. 



Investigation of the metabolic conditions and systematic 

 examination of the urine of animals from which the suprarenals 

 have been removed, has rarely been undertaken. According to 

 Alezais and Arnaud, the amount of phosphates in the urine of 

 rabbits is increased after extirpation of the suprarenals. Noth- 

 nagel considers that the indican reaction, sometimes afterwards 

 observed in the urine of rabbits, is due to secondary conditions. 

 Many authors report polyuria. 



Investigation of the metabolism of albumin was first carried 

 out with rabbits and cats after both single and double suprarenal 

 extirpation by Hultgren and Andersson. They found that there 

 was no change in the metabolism of albumin. Where the animals 

 were able to take nourishment, food containing a large proportion 

 of carbohydrates possessed the same property of storing up 

 albumin as in normal animals. Where the animals refused to 

 take food, the decomposition of albumin was the same as in the 

 normal fasting animal. 



Interesting information concerning the metabolism of the 

 carbohydrates in suprarenalless animals has recently been pub- 



