PHYSIOLOGY OF CORTICAL INSUFFICIENCY 171 



It may rightfully be argued that many of these manifestations 

 are merely terminal events which are encountered before death 

 from many causes. Thus a pre-mortem drop in blood pressure 

 is commonly seen in many conditions. The same may be true 

 of some of the other symptoms which develop late in insuf- 

 ficiency and which may be secondary to the primary disturb- 

 ance caused by removal of the vital hormone of the adrenal 

 cortex. Until we know definitely how the hormone acts in 

 the body it is impossible to form a clear concept of the sequence 

 of events which in their totality give the picture of adrenal in- 

 sufficiency. This picture will vary in individual cases depend- 

 ing upon the particular organs most affected in any given ani- 

 mal. Thus, whereas the immediate cause of death in a given 

 dog may be due to circulatory failure attributable to a dimin- 

 ished blood volume, hypoglycemia due to hepatic injury may 

 be the chief factor terminating life in a given rat. In both 

 cases other deficiencies contribute to the final fatality. 



