![]() The isolation of distinct corticosteroids that regulated carbohydrate metabolism or fluid and electrolyte balance led to the concept that the adrenal cortex comprises two largely independent units: an outer zone that produces mineralocorticoids and an inner region that synthesizes glucocorticoids and androgen precursors. Subsequently, Tait and colleagues isolated and characterized a distinct corticosteroid, aldosterone, which potently affected fluid and electrolyte balance and therefore was termed a mineralocorticoid. The isolation and identification of the adrenal steroids by Reichstein and Kendall and the effects of these compounds on carbohydrate metabolism (hence the term glucocorticoids) culminated with the synthesis of cortisone, the first pharmacologically effective glucocorticoid to become readily available. It later was shown that the adrenal cortex, rather than the medulla, was essential for survival in these ablation experiments and that the adrenal cortex regulated both carbohydrate metabolism and fluid and electrolyte balance. These studies were soon extended when Brown-Séquard demonstrated that bilateral adrenalectomy was fatal in laboratory animals. Addison described fatal outcomes in patients with adrenal destruction in a presentation to the South London Medical Society in 1849.
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