The purposes of surgery of the human adrenal glands are to remove neoplasms of these structures or to abolish functional activities which are deleterious to the organism; both conditions may be coeval. The principle of abolition of dangerous physiological functions of the adrenals, of course, is the opposite to stimulation of these glands by a corticotrophic agent, for example, corticotrophin (ACTH). There are several clear indications for the removal of nonneoplastic adrenals at present; no doubt more will be found, and the subject will assume greater importance. Frequently disease conditions caused by adrenal hyperfunction or those mediated through normal activity of these glands can be cured or alleviated by surgical procedures, with impressive results.
Adrenal surgery is now in a fast-moving evolutionary stage. Recently there have been four major developments in this area. These are (a) methods of maintenance of life in the absence of the adrenal glands or in