CORTICOTROPIN (ACTH) AND ADRENAL HORMONES DURING OPERATIVE STRESS IN ENDOCRINE DISEASE

Abstract
WIDESPREAD interest in the application of corticotropic and steroid hormone therapy to a diverse number of unrelated nonhormonal diseases has overshadowed the value of these drugs in endocrine disorders. This article deals with the more logical and specific application of the newer hormone preparations to endocrine deficiency states, with special emphasis on their value for protection against operative trauma. Poor response to surgical stress is a dominant feature of many deficiency states but is particularly significant in panhypopituitarism, Addison's disease, and functioning adrenal tumors with contralateral adrenal atrophy. PITUITARY DEFICIENCY Surgical therapy is a frequent necessity in the treatment of patients with pituitary failure, not only because the basic disease process often requires operative intervention, but also for the reason that these patients are subject to many of the surgical conditions which affect the endocrinologically normal population. Under conditions of stress, either incidental or coincidental to the basic glandular disease,