192 CORTEX 



ficiency of these ions. According to Britton and Silvette, 91 

 adrenal insufficiency in the opossum {Didelphys virginiana) and 

 marmot (Arctomys monax) is accompanied by blood serum 

 sodium and chloride levels which are greater than normal. 

 Apparently, in these animals, the renal injury is not a pre- 

 dominant factor in producing the effects of adrenal insuffi- 

 ciency. If one assumes that the adrenal cortical hormone is 

 essential for the normal function of several organs, or perhaps 

 even for all of the tissues, one would expect different species or 

 different animals of the same species to manifest symptoms 

 which are attributable to different deficiencies. Thus, whereas 

 a given dog may die of an acute disturbance of the electro- 

 lyte and water balance due to renal injury, a marmot might die 

 of carbohydrate deficiency due to hepatic injury. Remedying 

 either of these deficiencies may temporarily postpone death, 

 but ultimately some more fundamental disturbance, the nature 

 of which we are still ignorant, will result in death from adrenal 

 cortical insufficiency. 



THE ELECTROLYTE DISTURBANCE IN MAN 



In Addison's disease one also finds the same disturbances in 

 blood chemistry as are observed in the experimental animals. 

 Hypoglycemia may reach convulsive levels in moribund pa- 

 tients. Rowntree 538 observed an increase in the blood urea in 

 patients which was in proportion to the degree of adrenal 

 insufficiency. 



MarafLon and Collazo 428 in seven patients dying of Addison's 

 disease found the water content of muscle (obtained by biopsy) 

 to be 75 per cent as compared to 80 per cent in normal individ- 

 uals. The water content of the blood of 24 patients with this 

 disease averaged 76.8 per cent compared to 82 per cent for 

 normal individuals. The potassium content of the blood 

 serum was 31.1 mgms. per cent as compared to 20 for the 

 normal. On the other hand the sodium and chloride concen- 

 trations were not markedly deranged. 



