Clinical Syndromes due to 

 Suprarenal Diseases 



Hypoadrenia 



BENSON A. COHOE 



PITTSBURGH 



The growing interest in diseases of the endocrin organs, during the past 

 quarter of a century, has stimulated clinicians in an endeavor to recog- 

 nize the clinical manifestations of states of altered function of the supra- 

 renal glands. The limitation of our knowledge of the function of these 

 hodies has served to render this task especially difficult. In the opinion 

 of certain physiologists, this knowledge is as yet too meager to justify 

 clinicians in diagnosing any syndromes due to states of overfunction or 

 underfunction of the glands. A similar view has been shared by several 

 clinical authorities, who have pointed out a further obstacle, in that 

 any specific and characteristic symptoms, due to impairment or loss of 

 function, are wanting, as evidenced by the fact that autopsy records have 

 repeatedly demonstrated that extensive p&thological alterations in the 

 suprarenal glands may occur in the entire absence of any symptoms during 

 life, suggestive of suprarenal involvement. It may be recalled that Leube, 

 in his work on diagnosis, dismisses the subject with the statement that 

 diseases of the suprarenal glands are incapable of diagnosis. In a re- 

 cent critique Stewart (y) (1921) comes to the conclusion that the concep- 

 tion of hypoadrenia, in the usual sense of the term, has but very precarious 

 scientific standing. 



The clinical phenomena associated with a state of underfunction of 

 the gland have been more carefully studied than those of overfunction. 

 The French clinicians have been especially aggressive in their efforts 

 to elaborate a syndrome arising from deficiency of adrenal secretion, 

 and occurring apart from the Addisonian form. of adrenal disease. Ser- 

 gent and Bernard (1899) were among the first to classify a symptomatol- 

 ogy of this nature. Various terms have been employed in the literature, 

 descriptive of this condition of underfunction of the gland, including such 

 designations as suprarenal (or adrenal) insufficiency, suprarenal (or 



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