The Suprarenal Gland: Its Function in Hypertension and the Counter-Shock Mechanism

Symington, Thomas (1950) The Suprarenal Gland: Its Function in Hypertension and the Counter-Shock Mechanism. MD thesis, University of Glasgow.

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The chrome reaction is demonstrated and an explanation given of the reaction. The in-vitro results suggest that adrenalin is held in the phaeochromocyte cell as a protein complex which breaks down with disintegration of the cell and liberation of the active pressor substance directly into the blood stream, via the sinusoidal spaces. The adrenalin so liberated is responsible for the attacks of paroxysmal hypertension which occur in the adreno-sympathetic syndrome. There is no doubt that patients with chromaffin tumours may progress in time to a persistent type of hypertension which is associated with vascular and retinal changes. However, a study of the literature on those cases indicates that the vascular damage need not be irreversible, and surgical intervention is always indicated although it is better to operate as early as possible. The aetiology of chronic hypertension, associated with chromaffin tumours, like that of essential hypertension, is still unsolved, but new suggestions are put forward in an attempt to correlate recent experimental findings. There is no doubt that injections of adrenalin into experimental animals result in an immediate and sustained liberation of sugar-active corticoid from the suprarenal cortex. The amount liberated appears to be considerable and represents the counter-shock phase of Selye's alarm reaction. At no time was there any evidence of the liberation of salt-active corticoid which produces vascular lesions in the kidney similar to those caused by the Goldblatt clamp. It must be noted that the method of detecting salt-active corticoid activity is not so satisfactory as that used for sugar-active corticoid, and until the mechanism governing the liberation of salt-active corticoid is known, the part played by the suprarenal in hypertension must still remain obscure. In a final attempt to uncover this mechanism by injecting multiple daily doses of adrenalin, haemorrhagic lesions were seen in the suprarenals. The relationship between those haemorrhages and the Waterhouse-Friderichsen syndrome is discussed and an explanation of the syndrome suggested.

Item Type: Thesis (MD)
Qualification Level: Doctoral
Keywords: Medicine, Endocrinology
Date of Award: 1950
Depositing User: Enlighten Team
Unique ID: glathesis:1950-79799
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 03 Mar 2020 10:34
Last Modified: 03 Mar 2020 10:34

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