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May 31, 1941


Author Affiliations

Professor of Medicine, Columbia University NEW YORK
From the Departments of Medicine and Neurology, College of Physicians and Surgeons, Columbia University, and the Presbyterian Hospital and Neurological Institute.

JAMA. 1941;116(22):2495-2500. doi:10.1001/jama.1941.62820220007009a

CLINICAL PICTURE OF ADRENAL CORTEX INSUFFICIENCY  The syndrome of adrenal cortex insufficiency was first described by Thomas Addison, in his classic treatise, published in 1855. This symptom complex as observed in Addison's disease is characterized by an insidious onset and progressive development of fatigability and asthenia to the point of utter exhaustion, associated with varying degrees of anorexia, nausea and vomiting. Very occasionally diarrhea and abdominal pain are present. The symptoms may appear in the course of weeks, months or even years. At times, however, the tempo of the disease may be greatly accelerated. This may occur either spontaneously or in response to a withdrawal of sodium salts from the diet, or in association with an acute infection, and may, in the course of a few days, terminate fatally. These abrupt episodes of adrenal insufficiency are termed "crises." In a few instances the symptoms and signs of hypoglycemia may dominate