500 CHEMICAL PATHOLOGY OF THE DUCTLESS GLANDS 



alin or adrenal extracts, as before mentioned, will not counter- 

 act the loss of the adrenals. Thus, in 97 cases of Addison's 

 disease collected by Adams, 1 treatment with adrenal extract 

 caused some improvement in 31, 43 were not benefited, 7 were 

 made worse, while but 16 were permanently improved. In three 

 cases in which grafting of adrenal tissue was performed, the 

 patients seemed to have been made worse. It is possible that 

 the cortical and medullary portions have different functions, 

 since the latter, which contains most of the adrenalin, 2 origi- 

 nates in the sympathetic nervous system, while the cortex is 

 formed from the same embryonal tissue elements as the kidneys 

 and the generative glands. In rabbits the cortex hypertrophies 

 during pregnancy ; in frogs seasonal variations in structure 

 occur, corresponding to the period of mating; and cases of sex- 

 ual precocity have been found associated with adrenal hyper- 

 trophy, while cases of defective sexual development have been 

 found associated with adrenal atrophy. Therefore, it seems 

 probable that the cortical portion has to do with the generative 

 organs. Karakaseheff 3 believes, however, that Addison's dis- 

 ease depends upon lesions of the adrenal cortex, since the 

 medullary part may be entirely destroyed without the appear- 

 ance of the disease. The view that a diseased condition of the 

 semilunar ganglion, or of the entire sympathetic nervous sys- 

 tem, is the cause of Addison's disease has been long held by 

 many, and undoubtedly bears some relation to the observation 

 of Langley, 4 that the effects produced by adrenalin upon any 

 tissue are such as follow excitation of the sympathetic nerve 

 which supplies the same tissue. 



The amount of adrenalin secretion seems to be little modified 

 by disease or drugs (atropin), according to Ehrmann, 5 although 

 in acute experimental infections in animals the amount present 

 in the gland seems to be decreased. Adrenalin is not readily 

 destroyed by postmortem autolysis of the glands. 6 In chronic 

 insanity Mott and Halliburton 7 found the adrenals atrophied 

 and deficient in adrenalin ; this condition seems to be due to the 

 chronic disease and not specifically related to the insanity, and 

 the authors suggest that defective vascular tone in chronic dis- 

 eases may be partly dependent upon adrenal atrophy. 



Practitioner, 1903 (71), 472. 



2 See Abelous, Compt. Rend. Soc. Biol., 1905 (59), 520. 



'Ziegler's Beitr., 1904 (36), 401. 



4 Jour, of Physiol., 1901 (27), 237. 



5 Arch. exp. Path., 1906 (55), 39. 



6 See Gazette degli Osped., 1896, No. 12. 



7 Jour, of Physiol., 1906 (34), p. iii. 



