IN 1912, Lewy1 described cytoplasmic hyaline inclusions in the substantia innominata and the dorsal vagal nucleus in paralysis agitans. Trétiakoff2 described these inclusion bodies in the substantia nigra. In a previous paper3 I discussed the significance attached by various authors to these Lewy bodies, demonstrating additionally by a lipid-histochemical study that these Lewy bodies contain sphingomyelin.
The next question concerned the relationship between the partial disintegration of such structures as the substantia nigra (in Parkinson's disease) and the disturbed catecholamine metabolism in the basal nuclei on the one hand4 and sphingomyelin storage on the other hand. There is one organ in the body which is a veritable catecholamine plant: the medulla of the adrenal gland. This is why an investigation was made into a possible disturbance of lipid metabolism in the adrenal glands in two patients with Parkinson's disease. As a control the adrenal