The evolution of modern therapy in Addison's disease and its application in several illustrative cases

Abstract

1. The treatment of Addison's Disease is traced from its inception to the present time and the principles underlying the various forms of modern therapy are propounded and discussed.2. All cases of Addison's Disease that have entered hospitals in the Edinburgh area in the period 1927 - 1938 are reviewed and their treatment analysed.3. Original investigations into the different forms of modern therapy have been carried out and the results are presented.4. It is shown that cortical extract is undoubtedly beneficial when administered by itself and that its use is essential in times of "crisis".5. The effect of Cortical extract is greatly enhanced by the coincident use of sodium chloride or abundant salines.6. Evidence is produced to show that between the crises the administration of cortical extract is not necessary, provided that a high sodium chloride and a low potassium intake are maintained, and that no intercurrent toxic condition arises.7. It is demonstrated that a high potassium intake in Addison's Disease is detrimental, but tais may be "covered" if ample cortical extract is given or if the sodium intake is sufficiently high.8. It is suggested that all cases of Addison's Disease should have a diet with a low potassium content, and the difficulties underlying the preparation of such a diet are discussed.9. Several typical food:- stuffs are tabulated according to their potassium content and a suggested low potassium diet is outlined.10. Cases of Addison's Disease are described illustrating the application of the above conclusions.