38 Salt Treatment and Adrenalectomy 



stock diet, was given 4 cc. of 5.0 per cent sodium chloride four times a day by 

 stomach tube— a daily intake of 1,234 mg. of sodium chloride per rat. None of 

 the rats of the first group (low salt) survived beyond the 30th day postadrenal- 

 ectomy. The rats of the second group (1.0 per cent sodium chloride) remained 

 in excellent health for about 5 months. The animals of the third group (high 

 salt) did not survive beyond the 28th day, the average survival period being 

 19.5 days. The latter finding suggests that the adrenalectomized animal is more 

 sensitive to the injurious effects of a high salt intake than is the normal animal. 



Reference has already been made in this paper to Harrop's'^ success in main- 

 taining adrenalectomized dogs over a long period of time on salt therapy. 

 There is no doubt that his dogs received an optimal amount of sodium. Dogs 

 weighing 8 kg. received 5 gm. sodium chloride and 2 gm. sodium bicarbonate 

 daily in divided doses dissolved in small amounts of water and administered 

 by stomach tube. The reason given by Harrop for the use of sodium bicarbon- 

 ate with the sodium chloride was to avoid an acidosis. Loeb^^ has expressed 

 the view that in his experience with patients the addition of sodium bicarbon- 

 ate "has rarely proved necessary." He has recommended that 7 to 20 gm. of 

 salt in addition to the salt of the diet be given to patients not receiving specific 

 hormone therapy. 



The salt requirement in adrenal deficiency depends to some extent upon 

 the potassium intake: the higher the potassium the greater the need for so- 

 dium. Zwemer and Truszkowski" have emphasized the susceptibility of adre- 

 nalectomized animals to the ingestion of potassium salts. Allers and KendalP 

 showed that a low potassium diet in addition to a high intake of sodium 

 chloride and sodium citrate permitted adrenalectomized dogs to continue in 

 good health for many months. 



3. Urinary Excretion of Sodium and Potassium 



The urinary exretion of sodium and potassium is altered in adrenal insuffi- 

 ciency. Loeb, Atchley, Benedict and Leland^^ first showed a marked increase 

 in the renal excretion of sodium in dogs suffering from adrenal insufficiency. 

 Because of this wastage of sodium in adrenalectomized animals, it has been 

 assumed that the benefit derived from the giving of sodium chloride to such 

 animals is due to a replenishing of the lost sodium (Hartman^). 



A different interpretation has been suggested by Anderson and Joseph,^" 

 namely that sodium chloride given to adrenalectomized animals restores the 

 mechanism responsible for the normal excretion of sodium and potassium. 

 This view is supported by the data summarized in tables 1 and 2 (Anderson, 

 Joseph and Herring^''). The methods used have been described by Anderson 

 and Joseph." Four groups of rats were given either radioactive sodium or 

 radioactive potassiuin in isotonic solution intraperitoneally, and the percent- 

 age of the total dose excreted in the urine in 48 hours was determined. The 

 total amounts of regular sodium and potassium excreted by all groups were 

 also measured. In order to compare the rates of excretion of sodium and 



