HISTORICAL 5 



During the middle of the nineteenth century advances were 

 made in the anatomical study of the adrenals. The work of 

 Pappenheim, Schwager-Bardleben, Henle, 293 and others laid 

 the foundation for the comprehensive study of the minute 

 anatomy of the glands. 



Ecker 169 first demonstrated the glandular nature of the 

 adrenal cells and concluded that these organs must pour some 

 secretion into the blood either directly or by way of the 

 lymphatics. 



Kollicker (1854) in his "Microscopischen Anatomie oder 

 Gewebelehre des Menschens" gave a good microscopic descrip- 

 tion of the adrenals. Arnold 19 first introduced the conven- 

 tional division of the gland into zones while Leydig's 396 studies 

 demonstrated the relation of the adrenals to the nervous sytem. 



The modern study of the physiology of the adrenals may be 

 said to have begun with Thomas Addison. 7 His classic descrip- 

 tion of the disease of the adrenals, which has since been asso- 

 ciated with his name, initiated a series of researches which 

 have continued unabated to the present day. Addison's de- 

 scription, published in 1855, is one of the classics of medical 

 literature, and remains today an accurate and almost com- 

 plete account of the syndrome observed in the disease. Al- 

 though many cases of Addison's disease have been carefully 

 observed by subsequent workers, little has been added to Ad- 

 dison's description of the clinical symptoms and course of the 

 disease. It is remarkable that despite the characteristic symp- 

 toms of this morbid condition, only three accounts of the 

 disease are known which pre-date Addison's description. The 

 earliest case on record is the fragmentary account by Jose de 

 Sigiienza 426 in his "Historia de la Or den del glorioso doctor San 

 Jeronimo." Not only did Addison recognize the condition as 

 a morbid entity but he also accurately correlated it with a 

 pathological state of the adrenals. Addison's work served as 

 a stimulus for a number of clinical studies as well as for the 



