36 Salt Treatment and Adrenalectomy 



attended the work of Stewart and Rogoff."'^ They were the first to effect a sig- 

 nificant increase in the survival period of adrenalectomized animals by giving 

 sodium chloride. Their adrenalectomized dogs received Ringer-dextrose solu- 

 tion, 10 cc. per kilogram body weight per day, by the intravenous route. Not 

 only did this treatment prolong the survival period but it kept the animals in 

 a state of good health. In some instances the Ringer-dextrose solution rescued 

 comatose animals and enabled them to live for several weeks. Of seventeen 

 adrenalectomized dogs so treated, eight survived beyond the eighteenth day; 

 of these, three lived between 30 and 40 days, and one 54 days. The untreated 

 controls survived on the average of 7 days. Stewart and Rogoff believed at 

 that time that the symptoms of adrenal insufficiency were due to the presence 

 of a toxic substance and that the intravenous injections were beneficial by 

 virtue of "washing out of the poison." 



Much the same results were obtained by Marine and Baumann^on adrenalec- 

 tomized cats. The administration of 0.9 per cent salt solution intraperitoneally 

 (a total of 0.45 gm. sodiuin chloride daily) enabled the adrenalectomized cats 

 to survive for an average of 15 days, the shortest survival period being 7.3 

 days and the longest 30.8 days. They observed that physiological salt solution, 

 Ringer's solution, and isotonic sodium acetate were about equally effective in 

 prolonging life; moreover they noted that a hypertonic solution of salt defi- 

 nitely shortened the survival time. Isotonic glucose had virtually no effect on 

 the outcome. They suggested that sodium might have a "specific action" in 

 the prolongation of life. 



Clinical application of these findings was initiated by Loeb." A patient with 

 Addison's disease given sodium chloride (7 gm. daily) was kept in a state of 

 relatively good health for more than 6 months. An adrenal crisis was precipi- 

 tated in this patient by lowering the salt intake and prompt relief was obtained 

 by resuming the use of sodium chloride. 



Following these fundamental observations there have appeared numerous 

 confirmatory reports on the effects of salt on the adrenalectomized animal. 

 Rubin and Krick'" showed that adrenalectomized rats given salt in their drink- 

 ing water remained in a state of good health for a period of 4 months. Swingle, 

 Pfiffner, Vars and Parkins" found in adrenalectomized dogs that the feeding 

 of sodium chloride somewhat prolonged the interval between cessation of 

 adrenal cortical hormone therapy and the onset of adrenal insufficiency. Three 

 of their seven adrenalectomized dogs survived 19, 21, and 50 days, respectively, 

 on sodium chloride after injections of hormone had been discontinued. When 

 salt was withdrawn from the diet of the animal that had survived 50 days, it 

 exhibited in 4 days a severe adrenal insufficiency. Even better results on sodium 

 therapy in the dog were obtained by Harrop, Soffer, Nicholson and Strauss;^ 

 their adrenalectomized dogs were maintained in apparently normal condi- 

 tion over periods up to 5 months with no other therapy than sodium chloride 

 and sodium bicarbonate. 



Continuing the study on the use of sodium chloride in adrenalectomized 



