The Chemistry of the Steroids

necroses sometimes resulted with the steroid "conditioning" itself. An increased incidence of the necrotic changes in the myocardium was produced by dietary supplements of various sodium salts, especially sulfate, phosphate, and perchlorate. Whereas sodium salts predisposed to or enhanced the production of myocardial necrosis, potassium and magnesium salts protected the myocardium from damage. The anionic constituent of the sodium, potassium, or magnesium salt used was found to be an important factor in determining the activity of a given compound. "Conditioning" was also attempted by the use of other steroids. Simple stresses were found to increase the incidence of myocardial necroses in steroid-treated rats. A portion of the monograph deals with re-interpretation of the previously reported experimental and clinical findings of others in the light of Dr. Selye's information. The author concludes that steroids may "condition" the animal heart for the development of necroses following exposure to various sodium salts or nonspecific stresses. He describes a resemblance of the experimentally produced lesions to such disease entities as Fiedler's myocarditis, and myocardial infarction without coronary occlusion. The fact that certain salts of potassium and magnesium were found to protect the rats from the experimental lesions raised the possibility to Dr. Selye that future therapy of clinically observed myocardial necroses might include the use of these electrolytes. Readers who dislike multiple titles and subtitles that break up the continuity of their reading may find Dr. Selye's monograph trying in its carefully outlined style. The lesions produced by the author in "conditioned" rats bear a marked resemblance to the lesions of hypokalemia. The studies are not complete and the exact pathogenesis of the necroses has not been clarified. Although the author states that "there is no evidence to prove that the same labile biochemical system that is so readily deranged by corticoids and electrolytes in animals also exists in man . . . ," throughout the book he repeatedly refers to clinical situations, and by such associations appears to be a salesman of the idea that the experimental and the clinical are one and the same. This concept, however unacceptable, is a stimulating feature of the monograph to the clinically oriented reader.