194 CORTEX 



attributed to incomplete adrenalectomy. Animals which 

 would normally succumb to the effects of an adrenalectomy 

 may in the presence of microscopic nests of interrenal tissue 

 manifest no signs of adrenal insufficiency when supplied with 

 adequate doses of inorganic salts. The withdrawal of the salt 

 may even throw the animals into adrenal insufficiency and lead 

 to death. However, in these cases, some adrenal cortical 

 tissue is present and it is only by microscopic section of the 

 adrenal sites that this tissue is demonstrable. It is preposter- 

 ous to claim that gross post-mortem examination revealed no 

 accessory cortical tissue, for in the rat, at least, the small nests 

 necessary for maintaining life in the presence of salts are not 

 detectable by the naked eye among the connective tissue which 

 abounds at the site of the adrenals. 



The deficiencies in the organism brought about by a loss 

 of sodium chloride from the body are pronounced in their 

 effects, but are readily remedied by the administration of an 

 excess of salt. This fact has led investigators to misinterpret 

 certain of their observations, and conclude that the adminis- 

 tration of salts to an adrenalectomized animal 266 - 541 or to pa- 

 tients suffering from Addison's disease 351 offers a complete 

 replacement therapy. This view is entirely misleading. Al- 

 though useful in mitigating the symptoms due to loss of elec- 

 trolyte from the body, the administration of salts does not 

 serve as a replacement therapy for the cortical hormone. 

 Neither adrenalectomized animals nor man can be maintained 

 on such therapy beyond a reasonable period of time. 



Another current misconception is based on the view that 

 the administration of both an excess of salt and of the cortical 

 hormone is necessary to supply a complete replacement therapy 

 in adrenal insufficiency. Adrenalectomized animals or pa- 

 tients with Addison's disease maintained on inadequate doses 

 of the cortical hormone will react much more favorably when 

 an excess of salt is simultaneously administered with the 

 hormone, than when they receive an insufficient amount of 



