Just above the kidneys lie glands which in recent years have assumed so much significance that the knowledge concerning them has created a new era in medicine.
The adrenal glands contain two portions, known as inner and outer, or medulla and cortex. The inner portion of the adrenal glands is related to the sympathetic nervous system and provides the body with a substance that people call “adrenalin.” This substance has other names, like epinephrine and suprarenin. There is no disease associated with insufficient action of the inner portion of the adrenal gland, because the body can compensate through other mechanisms for lessening secretion. Excessive functioning of the medulla of the adrenal gland is associated with paroxysmal periods of high blood pressure and other signs of excessive stimulation of the sympathetic nervous system, including dizziness, sweating, a rapid pulse, palpitation, and changes in the blood. Since tumors may occur in the adrenal gland as well as elsewhere in the body, a tumor of the inner portion of the adrenal gland is accompanied by all of these symptoms. This indicates surgical removal of such tumors as soon as their presence is determined.
The outer portion of the adrenal gland is a shell made up of cells which create hormones called “steroid hormones.” At present, physiologists believe that there are as many as twenty-six different hormones developed by the cortex of the adrenal gland. Six of these have been isolated and two of them are known as Compounds E and F or Cortisone and Cortone. The cortex of the adrenal gland is stimulated to give off these hormones by a substance coming from the pituitary gland called ACTH or adrenal cortex trophic hormone.
Among other functions, the hormones from the cortex of the adrenal gland can regulate the distribution and secretion of sodium, potassium and chlorides by the body; they can regulate the water balance; they are concerned with the quantities of carbohydrates, protein, and fat used in the chemistry of the body; increasing particularly the use of protein and fat, and lessening the use of carbohydrates. They are concerned with the development of certain types of cells in the blood. They are also related to the keeping of nitrogen in the body, and they are related to the action of the sex hormones. Failure of the cortex of the adrenal gland to supply its hormones may create a variety of conditions, as will also excessive action.
When there is an insufficiency of the adrenal cortical material, the person suffers from insufficient sugar in the blood and from a variety of symptoms such as pain, lassitude, nausea, and circulatory collapse. A brown pigmentation of the skin appears which is typical of the disease known as “Addison’s disease,” named after the British physician who first recognized this condition. An extract of the adrenal cortex called desoxycorticosterone acetate has been prepared, which can be used to overcome the condition of disturbance of the handling of salts and water by the body.
Many tests have been devised which laboratories can perform to show the extent to which the cortex of the adrenal gland is doing its work. Excessive functioning of the gland may result in the development of conditions such as serious changes in the bones, swellings of the face and trunk, weakness and wasting of the muscles, thinning of the skin and difficulty in healing of wounds. Apparently the body must maintain a balance between the action of the various hormones coming from thepituitary and adrenal glands, because imbalance may result in serious changes in growth. In women, for instance, a condition called virilism may develop, with appearance of hair on the chest and face, rapid growth, and interference with usual functions.