Disturbances in adrenal function have thus far been recognized only at relatively late stages. The reason for this apparently is twofold. First, Wilks'1 paper, in which he rearranged and reclassified the cases on which Addison's2 original report was based, excludes all but those cases which can be placed in a very limited category. For instance, Wilks did not accept cases without pigmentation or without tuberculosis of the adrenal glands as being instances of Addison's disease. Thus he influenced adversely the recognition and diagnosis of partial adrenal insufficiency by the elimination of all cases but those with clearcut symptoms.
A second reason is that adrenal insufficiency, although constantly present to a degree, is openly manifest only at intervals over a given period of years. Thus, patients suffering from this disease receive an array of diagnoses, some of which are erroneous but all of which detract from adequate study of