=Adrenals.=--A new interest in the study of the adrenals in diseases of
the "deficiency" group has been created by the recent work of
McCarrison. This author found the adrenals increased in size and weight
in guinea-pigs dying of scurvy, whereas the adrenalin content of these
glands was markedly decreased. On section there was hemorrhagic
infiltration, "usually circumscribed in extent and situated around the
periphery of the adrenal cortex." This was seen even in early cases
before hemorrhage had occurred elsewhere in the body. He describes also
"degenerative changes in the cellular elements of cortex and medulla"
consisting of vacuolation and disintegration of the cells with
disappearance or loss of staining reactions of their nuclei. Rondoni,
some years previously, had called attention to this increase in size and
hyperæmia of the adrenals in guinea-pigs fed exclusively cereal diets.
He, as well as McCarrison, noted an increase, though much less marked,
as the result of starvation. LaMer and Campbell recently have confirmed
McCarrison's report of an augmentation in the weight of the adrenal
glands in guinea-pigs fed on diets deficient in the antiscorbutic
factor.
Comparable lesions have as yet not been found in human scurvy. These
glands have been found normal by Jacobsthal, Schoedel and Nauwerk,
Ingier and Epstein. In the cases of Aschoff and Koch no abnormality was
noted except an almost constant increase in lipoid content. In those of
Boerich the glands were normal in all but one case; in this instance the
medulla was somewhat increased in size. In passing, we may repeat that
Hart and Lessing found calcium deposits in the adrenals of four of their
five monkeys, a lesion which has never been recorded in man.
It is valuable in this connection to compare the adrenal in scurvy
with that of beriberi. In this disorder, Albert found the adrenal normal
in one case, and Andrews describes only congestion in his eighteen
necropsies. Ono found an increased adrenalin content in nine fatal
cases, and states that the medulla appeared "fatter" than normal. More
data will have to be obtained before it can be determined whether
characteristic changes occur in scurvy, and how to interpret the
hypertrophy described by several authors as common to guinea-pig scurvy.
=Pancreas.=--Sato and Nambu appear to be the only investigators who have
described lesions in the pancreas. They found hemorrhages in one case
among thirteen.
=Thymus.=--This organ has rarely been examined. Aschoff and Koch found
no abnormalities in adults, nor did Jacobsthal in a case of infantile
scurvy. Boerich noted enlargement in one instance.
=Other Organs of Internal Secretion.=--Very little attention has been
paid to these organs. Aschoff and Koch state that the thyroids and
hypophyses were normal in their cases.
=Generative Organs.=--No abnormalities have been described.
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