George H. Fried

Panel Discussion: Psychophysiological Properties of the Adrenal Cortex; Recent, Unpublished Advances

I T SEEMED FITTING to me that a panel devoted to the contemporary boundaries of our knowledge in psychosomatic medicine might profitably be introduced by a brief description of the corresponding state of affairs about one hundred years ago, when the adrenal glands acquired clinical significance. At that time, an extraordinary medical climate existed, in which many physicians whose names are illustrious today made their major contributions. For special reasons, I shall refer to Thomas Addison, Richard Bright, William Gull, and Thomas Hodgkin. In 1855, Thomas Addison wrote his classical paper entitled On the constitutional and local effects of disease of the supra-renal capsules. This article, which was the first to call attention to the functional importance of the adrenal glands, cites 12 cases, of which 11 underwent autopsy. Our panel today can be said to have been historically determined by this basic contribution and by the medical culture in which it originated. The disease of adrenal insufficiency was well established as a clinical entity in Addisons mind, in that several of the patients were correctly diagnosed antemortem. Dr. Gull, of whom you will hear more in a moment, Dr. Bright, and Dr. Hodgkin, each