Addison on the Symptoms and Treatment of Disease of the Supra Renal Capsules

R. M. HODGES
1856 Boston Medical and Surgical Journal  
We know so little of ihe physiology and pathology of the supra renal capsules, that it seems almost justifiable to follow the example of Hyrtl, who, in his excellent Anatomy, says nothing about them. Eut if our knowledge is so very limited, its inventory will be easy and perhaps not unprofitable. The physiology of the renal capsules is entirely conjectural. A few authors have advanced hypotheses, which others have been satisfied to repeat without endorsement, Their anatomical structure ((impels
more » ... ihe belief that they must have an important function. Filled with vessels and nervous ramifications, an organ so well supplied must have its office to perform. Moreover, it is almost never wanting, its absence being one of the rarest anomalies. Some anatomists and physiologists, taking their affinity to the kidneys into spécial consideration, have connected them with the uropoietic system. The simple fact, so ofien confirmed, that the capsules never accompany the kidneys in their congenital displacements, but always retain their place, overthrows this supposition. Others, relying upon some questionable observations in comparative or pathological anatomy, have supposed there must be some connection between ihe capsules and the organs of generation. This, M. Rayer has shown to be but an attempt to make a law from a few chance coincidences, consisting of one observation made by Otto, another by Lobslein, who found the left capsule tripled in size in an old syphilitic patient; and of a remark made by Meckel, who says that he has seen them very large in two debauchees. Their vascularily has suggested the idea, thai in htumatosis the capsules might perform an office somewhat analogous to that of the spleen or thymus gland.
doi:10.1056/nejm185609180550701 fatcat:znhxab63vjdshobunm537uwuhi