Abstract
It is apparent that strikingly beneficial effects from adrenal cortical hormone therapy may be anticipated with certainty only in those patients who present conclusive evidence of adrenal cortical insufficiency. Thus far despite numerous studies in patients with extensive burns, infections and surgical shock only five clinical conditions definitely associated with adrenal insufficiency are well established: (1) Addison's disease, (2) chronic adrenal cortical insufficiency without characteristic changes in pigmentation, (3) pituitary myxedema, (4) Waterhouse-Friderichsen syndrome and (5) acute adrenal cortical insufficiency precipitated by surgical removal of adrenal tissue. ADRENAL CORTICAL HORMONE Physiologic Considerations.— It is now recognized that adrenal cortical hormone plays an important role in the regulation of (a) sodium chloride, potassium and water distribution in the body, (b) carbohydrate metabolism and (c) pigment metabolism. Sodium, chloride, potassium and water distribution in the body is affected by the action of adrenal cortical hormone on the reabsorption of these elements by
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