SOME STUDIES OF POSTERIOR PITUITARY AND ADRENAL CORTICAL INTERRELATIONSHIPS IN PATIENTS WITH AND WITHOUT CIRRHOSIS OF THE LIVER 12

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Abstract
Admn. of Pitressin tannate led to a more pronounced antidiuresis and hyponatremia in those patients with cirrhosis of the liver. Hyponatremia resulted from (a) dilution of extracellular fluid by retained water, (b) increased Na excretion. A transfer of Na from extracellular fluid into the cell is suggested as another possible mechanism. Urinary excretion of corticosteroid rose when plasma Na concn. was markedly depressed but was not increased by Pitressin admn. per se. Admn. of adrenal cortical extract concomitantly with Pitressin promoted salt retention in only a few, and led to obvious diuresis in only 1 patient. It is suggested that the tolerance of the cirrhotic to antidiurectic hormone is not decreased sufficiently to account in itself for the production of ascites in Laennec''s cirrhosis.