Diagnosis and Treatment of Adrenocortical Insufficiency

ONE hundred and three years ago Thomas Addison (Addison, 1855) described the disease which now bears his name. Since his classical description, knowledge of adrenal disorders has widened and increased until it has developed into one of the most exciting and fruitful fields of clinical and biochemical research in the history of medicine. After Addison, many years had to pass before new chemical techniques were available to unravel the complexities of adrenocortical chemistry, but once research workers had mastered these methods, rapid and striking progress was made. In 1927, adrenal cortical extracts were prepared (Hartman, et. al., 1927; Rogoff and Stewart, 1927), which were capable of prolonging the survivMl time of the adrenalectomised animal. In 1930 the close connection between the pituitary gland and the adrenal cortex was demonstrated (Smith, 1930), when it was shown that hypophysectomised rats developed rapid atrophy of the adrenal cortex which could be avoided by transplants of anterior pituitary tissue, the active principle of which was later named adrenocorticotrophin or A.C.T.H.