THE CONQUEST OF ADDISONS-DISEASE

BACKGROUND: A review of the understanding and treatment of adrenal ins ufficiency was undertaken to emphasize common themes in the history of endocrine disorders, METHODS: Literature survey. RESULTS: The presenc e of the adrenal glands, initially ignored by anatomists, was first de scribed by Eustachius and later confirmed by Casserius, Bartholin iden tified the glands as ductless. In 1855, Thomas Addison described the c linical syndrome of adrenal insufficiency. Medullary hormonal effects were described by Oliver and Shafer in 1895; epinephrine was isolated by Takamini, and the secretory patterns were characterized by Cannon. Cortical function was elucidated by Biedl and Stewart and Rogoff, and the first cortical hormones were synthesized by Reichenstein. Hormonal replacement therapy paved the way for the first bilateral adrenalecto my, which was performed in 1950. CONCLUSIONS: This review underscores the historical themes in endocrine diseases: discovery of the glands, identification of their hormonal products, use of the hormones for the rapy, and biosynthesis for pharmacologic applications. (C) 1997 by Exc erpta Medica, Inc.