158 INTERNAL SECRETION 



Szymonowicz found that removal of the suprarenals was followed 

 by an increase in the number of the red blood corpuscles, while 

 Bornet describes a decrease in the red and an increase in the white 

 blood cells. But Hultgren and Andersson found that after very 

 exact experiment they were unable to show any change in the 

 haemoglobin contents of the blood and in the number of its cellular 

 elements. 



SUPPRESSION OF THE SUPRARENAL FUNCTION 



IN MAN. 



Complete suppression of the suprarenal function may occur 

 in man as the result of the congenital absence of these organs. 

 The accounts of the older authors of the absence, believed to be 

 congenital, of the suprarenals from the cadavers of adult persons 

 are entirely valueless, and are, in any case, very scanty. More 

 recently such a rinding has been described in .the case of one 

 person, aged 40, who had died of phthisis (Martini), and in one 

 boy aged 6 (Averbeck); but in these instances no account was 

 taken of the probable presence of accessory suprarenals. The 

 absence of one suprarenal which, as experiment seems to show, is 

 by no means dangerous to life, is of the rarest occurrence. 



With regard to hypoplastic infantilism of the suprarenals, 

 many instances of malformation have been described by J. F. 

 Meckel. Weigert, Lomer, Zander, point to the hypoplasia of the 

 suprarenals as a frequent occurrence in certain disturbances in 

 the embryological development of the brain, more especially in 

 anencephaly and hemicephaly. According to Zander, a reduction 

 in the size of the suprarenals is to be expected in cases where, at 

 a certain stage of embryonal development, the anterior portions 

 of the cerebral hemispheres have perished. Czerny found that, in 

 the five cases of congenital hydrocephalus which he examined, 

 there was complete absence of the medullary substance of the 

 suprarenals, the cortex remaining intact. 



Total aplasia of the medulla in adults has been occasionally 

 described as an accidental finding (Ulrich, Klebs). . In these 

 cases the suprarenals were atrophied, and consisted only of cortical 

 substance. The condition of the extracapsular chromaffine tissue 

 was not described. 



Special interest is attaching to Wiesel's findings of hypo- 

 plasia of the chromaffine system. One case was that of a girl of 

 eighteen with posteriolateral curvature of the spine, who died of 

 cardiac insufficiency. The second was in a case of sudden death 

 after heat stroke, and the third was in a youth of eighteen with 

 status thymicolymphaticus. Hedinger describes hypoplasia of 

 the chromaffine system in a number of cases of sudden death in 

 the status thymicolyphaticus. 



Acute suprarenal suppression is not infrequently brought 



