ACTH was isolated and characterized by Li and co-workers 20 in 1958, and CRH, in turn, was characterized by Vale and co-workers 21 in 1981. Cushing 18 largely clarified the role of the pituitary gland in regulating adrenal function, and Harris 19 in the 1940s clarified the role of the hypothalamus in regulating pituitary function. The clinical effects of cortisone soon were made apparent by the work of Hench and co-workers 16 in the treatment of rheumatoid arthritis, and by Thorn and Forsham 17 in the treatment of adrenal insufficiency. Wintersteiner and Pfiffner, 11 Kendall, 12 de Fremery and co-workers, 13 and Grollman 14 isolated and characterized cortisone and cortisol in the 1930s, and Sarett 15 devised a partial synthesis for cortisone from deoxycholic acid in 1945. 9 Osler 10 attempted unsuccessfully to treat a young patient with Addison’s disease, employing a glycerine extract of fresh pig adrenals given orally.

The clinical syndrome was named after Addison by Trousseau in 1856. Addison’s findings were quickly confirmed by Brown-Sequard (1856), 8 who verified Addison’s hypothesis in several laboratory animals and showed that bilateral adrenalectomy was a uniformly fatal intervention. Of the 11 patients who were described, 5 had bilateral adrenal tuberculosis, 1 had unilateral adrenal tuberculosis, 3 had carcinomatous adrenal involvement, 1 had adrenal hemorrhage, and 1 showed atrophy and fibrosis. 7 He showed that destruction of the adrenal glands in humans was associated with a fatal outcome.

6 The clinical importance of the adrenal glands was recognized by Addison, a British surgeon, and was described in one of the classic papers in medicine. Bartolomeo Eustachi in 1563 first recognized the adrenal glands as organs distinct from the kidneys. The recognition of this disease by Addison is generally accepted as the beginning of clinical endocrinology as a specialty. Bornstein, in Endocrinology: Adult and Pediatric (Seventh Edition), 2016 History

Symptoms of adrenal glands