1901 The Lancet  
1512 THE PHYSIOLOGY OF THE ADRENALS. and sees him as often as possible, for the child is out at nurse. LTnexpectedly she returns with the nurse and the child, for the country doctor has ordered that wet nursing should be given up and that the child should be fed with a bottle. Then the grandmother, wishing to get at the root of the matter, consults a specialist who, as every experienced playgoer must expect, turns out to be our friend of the first Act. The doctor asks to see the father of the
more » ... the father of the child and recognises his old patient. Madame 1'Avarie has escaped infection but the child has not. The wet-nurse ought no longer to run the risk of danger. So says the physician. But the grandmother wishes the nurse to stay, otherwise the child might die. What matter if the nurse runs a risk ? If she were infected they could pay her. However, the nurse chooses to go and demands her money, whereupon M. 1'Avarie refuses to pay. Then the nurse, touched in her pocket, turns on him and tells him that she knew the nature of the illness and Madame 1'Avarie overhears the end of the conversation In the third Act a new character appears, the father of Madame 1'Avarie, a " depute." " He is received at the hospital by the physician who presumes that he has come to get some information for use in the cause of hygiene. He has in reality come to obtain a certificate from the physician two enable him to sue for a divorce for his daughter who has returned to him. The physician declines. He also advises that the nature of the child's illness should be kept secret. 1 A cure is possible. A public scandal can never be 1 obliterated. He advises pardon, hope, and patience-1 patience for the present and hope for the future. So the play ( ends. That the scabrous theme of hereditary syphilis, i which has already been used as a motif by Ibsen, is here E treated by M. Brieux discreetly may be true, but the pro-1 duction of such work at a theatre cannot be recommended. t The lessons in practical life and morals may all be sound and IJ forcibly inculcated, but most people expect recreation and i the creation of pleasant emotions at the theatre ; they do not ( want instruction in the pathological sequelae of venereal a disease. We trus. that the play will not get a public f hearing. t article to a recent number of Pfliiger's <lre7tiv which contains the results of their researches on the physiology of the suprarenal capsules on which they have been engaged for the last three years in the Physiological Institute of the University of Konigsberg. They first occupied themselves with the question of the importance to life of these organs. Upon this point there has been much difference of opinion. Brown-Sequard in particular, who removed them entirely from the body, thought their presence was indispensable to life, since death was the invariable consequence of their removal. Subsequent experimenters, like Tizzoni and Nothnagel, opposed this statement, but in their method of operation the organ was not removed but only broken down in sittc. Neither by Brown-Sequard nor by the abovenamed observers was any dissection made to determine the presence or absence of accessory adrenals. Dr. Strehl and Dr. Weiss find that such structures, the presence of which, of course, invalidated the results of both sets of observers, are to be found occasionally in rabbits; in two cases they were situated behind the vena cava and in another in the substance of the cortex of the kidney, whilst two of the size of a bean were discovered in a cat which had survived without apparent injury the removal of both adrenals. Their operations to determine the results of total extirpation were performed on dogs, cats, rabbits, guineapigs, rats, mice, a hedgehog, and a weasel, and upon frogs ; for those made on rabbits, mice, and rats albinos were , selected. The removal was usually effected by laparotomy in the linea alba, though occasionally through the back cf the animal, the right adrenal being first removed on account of the greater technical difficulties attending the operation. Asepsis was carefully effected in every instance. Experiments were performed upon a number of other animals from which only one suprarenal capsule was removed. They were uniformly fatal in the ca-e of guinea-pigs, but the other animals appeared to suffer little inconvenience except that two dogs and a cat became thinner. In the animals which died after removal of both adrenals the symptoms observed were great muscular weakness and apathy ; the gait was vacillating, the legs straggled, and the head was depressed. The temperature slowly fell. The blood-pressure was found to be diminished to the extent of four or five millimetres of mercury after the removal of one adrenal, but when the second one was extirpated the blood-pressure at once fell 20 or 30 millimetres and continued to fall more slowly till death ensued. Transplantation of the adrenals even into part that were highly vascular, like the substance of the liver or kidneys, was never successful. Dr. Strehl and Dr. Weiss point out the difficulty of determining with certainty the cause of death, some attributing it to loss of nerve-power, others to the adrenals secreting or producing a substance which, entering the blood, keeps up the blood-pressure, and others to the adrenals destroying some substance proceeding from the muscles or other tissues and accumulating in the blood after their removal which would otherwise exercise a deleterious influence on the blood-pressure. The experiments in favour of the last-named view are that animals die much sooner after ablation of the adrenals if their muscles have e been previously tetanised ; whilst the injection into frog of the plasma of blood of warm-blooded animals from which the adrenals have been removed proves fatal, acting like curare in paralysing the end-organs of the motor-nerves generally. On the other hand, the researches of Oliver and Scha,fer and other observers seem to show that some substance is formed by the adrenals the action of which is to maintain the blood 'pressure. -BELATED HONOURS TO MEDICAL WORTHIES AN Italian contributor writes from Florence, Nov. 22nd: The Medical Congress which recently sat at Yi:a wound up its proceedings by an'impressive, if very tardy, acknowledgment of the obligations conferred on that seat of learning by the great anatomists and nature-students Andrea Vesalio and Andrea Cesalpino. The former, though not an Italian by birth, made Italy the scene of his most effective work, leaving on anatomy in all its departments the marks of true genius in research and of an expository power at once luminous, artistic, and fascinating. To commemorate these services a tablet inserted in the facade of the old Church of Our Lady of Snow (Santa Maria delle Nevi) opposite the University bears the following inscription :— In questo edificio fu l'anfiteatro anatomico dello Studio Pisano dove per primo insegnu
doi:10.1016/s0140-6736(01)74562-x fatcat:rizgwrpd3ffbflbyijn46zlwqm