THE ADRENAL CORTEX IN RHEUMATIC DISEASE

THE RESPONSE of certain rheumatic diseases to the administration of cortisone and the adrenal corticotropic hormone of the anterior lobe of the pituitary (corticotropin; ACTH) has aroused an interest in structural changes of the adrenal cortex in these diseases. The present study is a systematic investigation of the human adrenal cortex in persons with several rheumatic conditions and in persons receiving cortisone or corticotropin therapy. Although there are numerous well-controlled observations of the morphological variations of the adrenal cortex of laboratory animals in different physiological conditions, relatively little information is available concerning the human gland in systemic diseases. There is a fairly wide variation in the weight, size, and microscopic appearance of the cells that has not been clearly correlated with the general state except in obvious conditions of hypoadrenalism (Addison's disease) or of hyperadrenalism, as in certain cases of Cushing's syndrome. In addition to a careful histological examination of