The Adrenal Cortex

Arthur R. Colwell Jr., MD
JAMA. 1974;229(5):580-581. doi:10.1001/jama.1974.03230430072042.
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Written by the chairman of the Department of Medicine at the University of Southern California, the monograph begins with fetal development, guides the reader through biochemical formulas and pathways, covers hormonal pathophysiology, and ends with clinical concepts. A brief historical background pays tribute to the pioneers in the field. Anatomical concepts are based on embryological origin, and are illustrated by adrenal venograms and drawings. The average clinician may not pay attention to the rather complicated explanation for deriving the names of steroid compounds, but he should try to understand the pathways of biosynthesis, faithfully depicted with the methods of estimation of each hormone.

The normal pituitary-adrenal axis and the biological effects resulting from its derangement are of fundamental importance. Iatrogenic adverse effects of therapy suggest that "the cure may be worse than the disease," and a plea for alternate-day therapy correlates with other authoritative recommendations. Clinical paragraphs on Addison disease


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