Abstract

That substitution treatment of Addison's disease is not yet fully developed at first thought seems surprising. It is certainly not Addison's fault. In 1855 he not only described the disease but demonstrated its cause. This was seventeen years before Sir William Gull, his colleague at Guy's Hospital, merely described myxedema, and twenty-seven years before Kocher and Reverdin showed that myxedema is due to lack of thyroid tissue. In spite of this later start, myxedema is now easily treated with replacement therapy, while Addison's disease remains a problem. The knowledge concerning replacement therapy in other later described endocrine deficiencies, such as diabetes and parathyroid tetany, has likewise passed far beyond that in Addison's disease. Just as progress of knowledge in Addison's disease has been slow, so is evaluation of treatment difficult, and for the same reason. Science, in the final analysis, depends on measurements. No measuring stick has been found for

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