Above the kidneys lie two small bodies known as the adrenal glands. One portion of these glands secretes a substance now generally called adrenalin, which has the power of constricting the blood vessels and raising the blood pressure. Another portion of the glands, known as the cortex, which is the outer portion, secretes a different substance, generally called cortin.
The adrenal glands are necessary to life. If they are removed from the body of an animal, the animal dies. When the glands become infected with any organism which destroys their tissue, the destruction of the glands is followed by death.
More than seventy-five years ago a British doctor named Addison described the condition which is now known as Addison’s disease. Since 1927 extracts of the cortex of the adrenal glands of cattle have been prepared and are taken as a substitute for the cortex of the adrenal glands of the human being. When the adrenal glands are removed either surgically or by disease, a number of changes take place in the functions of the body. There is a progressive loss of salt and of water, which leads to a lessening of the amount of fluid circulating in the blood and of the amount of fluid in the cells of the body. The result of such a decrease in fluid is the appearance of shock. Associated, there will be a loss of weight, vomiting, muscle weakness, a lowering of the blood pressure and, finally, a lack of flow of urine. The muscular weakness is probably the most important manifestation of a lack of adrenal material in the body. This is the symptom of which patients complain first and most. Another symptom which attracts considerable attention, however, is the bronzing of the skin; this may involve not only the skin but also the mucous membranes of the body.
The discovery of cortin is now recognized as one of the greatest discoveries of modern medical science, since it makes possible the saving of life in cases which were formerly invariably fatal.
Each year not more than three to four hundred cases of this disease are reported in the United States. There are, however, instances in which there may be a depression of the function of the gland rather than a complete disappearance of its secretion. Under such circumstances the use of the preparation cortin or one of its substitutes may be helpful in controlling the symptoms.
An extract of the adrenal glands is now available under the name of desoxycorticosterone acetate. A more recent discovery—aldosterone—is much more powerful. The pure cortin is exceedingly expensive and difficult to secure. Usually Cortisone or the more potent Meticorten or prednisone is given.
There is a definite relationship of vitamin C to the function of the cortex of the adrenal gland, so that extra amounts of vitamin C are given also. Finally the elimination of sodium from the body in this disease is an im, portant factor in developing the weak, ness and the other symptoms, so that a high intake of sodium chloride and low intake of potassium are also con sidered to be essential.