498 CHEMICAL PATHOLOGY OF THE DUCTLESS GLANDS 



Miller. Franchini l found that administration of hypophysis 

 tablets had no effect upon the metabolism of an acromegalic. 

 Glycosuria is frequently present in acromegaly, and is also often 

 present in hypophyseal tumors without acromegaly. 2 



THE ADRENALS AND ADDISON'S DISEASE 3 



In common with the other ductless glands, the adrenals have 

 been considered by many as having for their chief function the 

 neutralization of poisons of metabolic or gastro-intestinal origin. 

 The evidence in support of this view is, however, by no means 

 conclusive. When the function of the adrenals is reduced 

 through pathological alterations (Addison's disease), or abolished 

 by experimental extirpation, a number of characteristic consti- 

 tutional changes follow. Most prominent is the profound mus- 

 cular weakness, which is more marked by early fatigue than by 

 weakness during a single effort. The decreased cardiovascular 

 tone is also striking, and a severe anemia is usually present. 

 Gastro-intestinal disturbance is marked, anorexia, nausea, vom- 

 iting, and diarrhea usually occurring. In man, pigmentation of 

 the skin and mucous membranes with a pigment resembling 

 melanin in appearance, is one of the most striking features, and 

 some evidences of pigmentation are occasionally observed after 

 experimental adrenalectomy. The exact nature of this pig- 

 ment, and the reasons for its accumulation in Addison's disease, 

 are both unknown. (Discussed under " Pigmentation," page 397.) 

 In experimental animals it has been found that the blood is 

 toxic for other animals, which is usually interpreted as meaning 

 that toxic products accumulate, which the adrenals normally neu- 

 tralize or destroy ; but it is equally possible that these toxic 

 substances are produced only after removal of the adrenals, and 

 not in normal metabolism. 4 The metabolism is decreased, but 

 no characteristic changes are observed (Neusser 5 ). 



Adrenalin. Administration of adrenal tissue to either 

 man or animals, while unable to compensate for loss of the 

 glands, has very profound effects. These are due chiefly, if not 



1 Bull. sci. med. Bologna, 1905 (75), 8. 



2 Launois and Roy, Arch. Gn. de MeU, 1903 (191), 1102. 



3 General review and literature given by Shaw, " Organotherapy," London, 

 1905. 



4 Sergent (Presse Med., 1903 (11), 813) describes as characteristic of " acute 

 insufficiency of the adrenals" a certain symptom-complex that simulates a 

 severe intoxication. Hemorrhage into the adrenals often causes acute symp- 

 toms resembling a profound intoxication, especially like peritonitis (see Sim- 

 monds, Virchow's Arch., 1902 (170), 242: Dudgeon, Amer. Jour. Med. Sci., 

 1904 (127), 134). 



5 Nothnagel's System, Bd. xviii, 3 Teil. 



