THE ADRENAL CORTEX AND HOMEOSTASIS

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Abstract
The effect of stress upon the secretory activity of the adrenal cortex is discussed under 6 heads Indices of rate of secretion of adrenocortical hormone covers anatomical, histologi-cal, and chemical changes in the adrenal cortex; metabolic changes in the organism and alterations in the lymphocytes and eosinophils; urinary steroids; and blood corticoids. Estimates of rate of secretion, and of rate of "utilization" and degradation of the adrenocortical hormone follow. 4 concepts of the nature of the secretion are given. Regulation of secretion by the pituitary, by a peripheral-humoral mechanism, by a central neural and neuro-humoral mechanism, and by the sympatho-adrenal system is discussed. Responses of the adrenal cortex to stress are classified. The influence of the secretion of the gland upon bodily function is taken up under these heads: increased rate of utilization of cortical hormone during stress; changes in the metabolism of carbohydrate, protein, fat, and electrolyte during stress; resistance to stress, including the question whether stress induces hypo-corticism, and concepts dealing with the mode of action of cortical hormone (detoxification, cardiovascular dynamics, mobilization of antibodies); adaptation to stress; and, finally, the problem, "Are pathological changes induced by the hyperactivity of the adrenal cortex which accompanies stress?" This last discussion deals with the "adaptation syndrome," "excessive" production of adrenocortical hormone, toxicity of desoxycorticosterone acetate, toxicity of adrenocortical extract, and 11, 17-oxysteroids, toxicity of anterior pituitary extracts and purified adrenocorticotropic hormone, pathology of Cushing''''s syndrome, production of "diseases of adaptation" in exptl. animals, adrenal cortex in relation to essential hypertension, allergic basis of rheumatic heart lesions and periar-teritis nodosa, deficiency of 11, 17-oxysteroids induced by desoxycorticosterone acetate, therapy of collagen diseases with cortisone and adrenocorticotropic hormone. More than 500 references are given.