Cortisone and its analogues in alimentary disorders.

The object of the present article is to discuss the uses and limitations of cortisone therapy in *diseases of the gastro-intestinal tract, liver and pancreas. The term cortisone will often be used generically to embrace all forms of corticosteroid therapy, but it must be appreciated that the various steroids are nQt in every case interchangeable, and in particular that corticotrophin (ACTH) has different actions from natural or synthetic adrenal steroids used singly. ACTH often appears to be the most effective form of treatment but it induces marked clinical evidence of hypercortisonism and mental disturbances are relatively common. The synthetic derivatives, A-cortisone (prednisone) and A-hydrocortisone (prednisolone) appear to be somewhat more effective than cortisone in corresponding doses, but there is evidence that they are more prone to create or activate peptic ulcers, so that, frequently, it is best to start treatment with cortisone or hydrocortisone and hold the more potent preparations in reserve.