By acute adrenal insufficiency is usually meant that group of cases in which, after a short fatal illness accompanied sometimes by severe gastrointestinal symptoms, sometimes by acute symptoms referable to the central nervous system, and sometimes merely by profound asthenia, or some combination of these, there is found at autopsy no adequate cause for death except some destructive process in the adrenal glands. The cases are distinguished from Addison's disease by their short course and by the absence of pigmentation. At autopsy the lesion is usually a thrombosis of the adrenal veins with hemorrhage into the medulla, but cases have also been noted of an acute inflammatory process, carcinoma, sarcoma or tuberculosis, involving the adrenal glands. Those cases of adrenal hemorrhage occurring in infants and, as is thought by many observers, resulting in some way from an acute infection, may also belong to this group.
COOKE JV. SOME OBSERVATIONS ON THE BLOOD-PRESSURE-RAISING SUBSTANCE OF THE ADRENALS IN ACUTE ADRENAL INSUFFICIENCY. Arch Intern Med (Chic). 1912;IX(1):108-113. doi:10.1001/archinte.1912.00060130113008