addison's disease 327 



insufficiency leads to a reduction in its concentration in the 

 body. It is to be expected therefore that replacement of the 

 lost sodium chloride will aid in preserving the well-being of the 

 patient. The experiments of Harrop and his collaborators 266 

 would indicate that the use of sodium chloride together with 

 bicarbonate of sodium is advantageous over the use of the 

 former substance alone. The administration of sodium chlo- 

 ride intravenously to patients in crisis has proven life-saving. 

 Ten to twenty grams of sodium chloride administered daily has 

 been of great aid during periods of remission from the more 

 severe stages of the disease. This salt or a mixture of sodium 

 chloride and sodium bicarbonate in the ratio of 2 : 1 by weight 

 may be administered in enteric coated capsules, in milk, with 

 lemon juice, etc. Z51 



Since disease of the adrenals is often accompanied by tuber- 

 culosis or other diseases it is of course essential to treat these 

 conditions. Even with a replacement therapy available, the 

 presence of the diseased adrenal remains a constant threat to 

 scatter the germs of tuberculosis through the body. 579 



In cases of syphilis, antisyphilitic treatment is indicated 

 although this must be carried out with great caution and only 

 after preliminary and continued treatment of the patient with 

 the cortical hormone. 



The problem of adrenal grafts has already been discussed in 

 Chapter XIX. A number of attempts have been made to 

 graft fetal adrenal tissue into the testis, ovary, or abdominal 

 connective tissue. The work in the past was of necessity 

 unsuccessful for the patient could not endure the operative 

 shock of the operation. More recently attempts have been 

 made to transplant cells derived from tissue cultures into the 

 axillary subcutaneous tissue. With a supply of the cortical 

 hormone available to carry the patient through the necessary 

 operative procedures, a new attempt at adrenal transplanta- 

 tion of fetal cortical tissue or tissue cultures is warranted. 



Although the results of the therapeutic management of Addi- 



