A Review of Adrenal Cortical Hypertrophy1

HYPERTROPHY of the adrenal glands has been described in a bewildering variety of circumstances, but few attempts have been made to determine the nature of the humoral or neural stimuli that may initiate the process. It is true that many workers in this field have used such phrases as ‘reaction to stress,’ ‘reaction to unfavorable environment,’ ‘alarm reaction,’ or ‘protective power of the adrenals’ but these concepts can be regarded as no more than vaguely descriptive, and therefore legitimate targets for more precise methods of analysis. The phrase ‘reaction to stress,’ in a general way, describes many of the conditions we propose to discuss, but it gives us no understanding of the possible mechanisms that may stimulate the adrenals to hypertrophy. Much of the work to be reviewed is difficult to evaluate for many reasons, some of which illustrate the inherent complexity of the problem.