#1. Evidence of suprarenal insufficiency has
been sought in 174 patients with tuberculosis.
Clinical features have been examined and the
level of sodium in the blood serum investigated.
#2. Serial sections of glands obtained at autopsy
showed suprarenal abnormality in eleven patients.
• Serum sodium above 315.
• • Three autopsies.
• • • One positive inoculation for tubercle
• Serum sodium below 315.
• • twenty -two autopsies.
• • • Seven positive on inoculation for
• Serial sections.
• • Two definite tuberculous lesions.
• • Pour small tuberculous foci.
• • One amyloid degeneration.
#3. Suprarenal insufficiency was diagnosed in four
patients, two showed tuberculous lesions of the
suprarenals, in one there was no evidence of disease
in the glands, while the other is untraced.
#4. The normal range of sodium has been assessed
as 315 to 350 mgms per 100c.cm. of serum.
#5. In 114 cases the level of serum sodium was
• In 60 cases the level of serum sodium was low.
#6. A low serum sodium indicates a bad prognosis.
#7. Such suprarenal lesions as were found, occurred with one exception, in Group with low serum sodium.
#8. Pigmentation of the skin was present only in
the group with a low serum sodium.
#9. Cases with pyrexia, sweating, diarrhoea or
vomiting did not have of necessity a low serum
#10. There is no proof that serous effusions or
purulent discharges can drain away sufficient
sodium to account for the low level, nor that
they upset the sodium balance.
#11. There is no evidence that cases with a low
serum sodium had a low enough sodium intake to
explain the decreased serum level.
#12. Even with a low sodium intake there is an
appreciable loss of sodium in the urine.
#13. In the presence of a low serum sodium
continued excretion of sodium in the urine suggests
suprarenal damage, even'with a low intake.
#14. In the absence of factors such as severe vomiting
or diarrhoea a low serum sodium is suspicious
evidence of suprarenal insufficiency.