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August 14, 1937

SIGNIFICANCE OF THE INCREASED FREQUENCY OF SELECTIVE CORTICAL NECROSIS OF ADRENAL: AS A CAUSE OF ADDISON'S DISEASE

Author Affiliations

CHICAGO

From the Department of Pathology of the University of Chicago and the Otho S. A. Sprague Memorial Institute.

JAMA. 1937;109(7):490-493. doi:10.1001/jama.1937.02780330018007
Abstract

The increasing frequency of contacts with new chemicals, whether in industries or in therapeutics, is bringing about new disease conditions. The picture of some diseases is being modified, the frequency of other pathologic states is being made greater or less, and possibly entirely new conditions are being produced. Unfortunately the harmful effects of therapeutic agents or industrial poisons commonly are not recognized until much damage has been done. Chloroform had been widely used for half a century before the menace of toxic necrosis of the liver was generally recognized and the use of chloroform for anesthesia largely abandoned. Despite numerous early admonitions, it was not until after 1900 that chloroform necrosis was found to be a widespread and common occurrence which had usually escaped recognition because designated as something else, e. g., puerperal acute yellow atrophy, when it followed delivery under chloroform.

The liver indeed is particularly susceptible to damage from toxic chemicals, and many agents besides chloroform produce the appearance of "acute yellow atrophy." During the war this condition was observed frequently as a result of absorption of chemicals used in making explosives and other war materials. In the prohibition era there was also a heightened incidence of similar conditions produced by the unbelievable consumption of

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