The Effect of Infection and Trauma on the Excretion of Urinary Cortin.

Adrenal cortical hyperplasia which is known to occur during infection and after trauma (1, 2) suggests the occurrence of a corresponding increase in the physiological activity of the gland. Scant information is available, however, bearing directly on the functional status of the adrenal cortex during conditions of stress. It would be important to know not only whether periods of stress are accompanied by increased cortical function, but also whether recovery might be influenced by the functional state of the adrenal cortex, and whether such conditions as post-infectious asthenia might be attributable to adrenal exhaustion resulting from extreme stimulation during the active phase of thedisease. Although the excretion of neutral 17-ketosteroids is influenced by adrenal cortical function, the chemical determination of these steroids affords a poor measure of the activity of the gland, inasmuch as the adrenal is not the sole source of the compounds in this fraction. Moreover, information as to the precursors of urinary 17-ketosteroids is far from complete. The one classical precursor, testosterone, has insignificant cortinlike activity. Browne and coworkers demonstrated the presence of cortin-like activity in the urine of postoperative patients and patients suffering infection or other types of stress, but were not able to detect the material in normal urine (3a and b). Evidence has recently been adduced that the substance is present in the urine of normal men and women who have not been subjected to stress, and that it possesses the physiological properties of cortical hormone when tested by a great variety of methods (4 to 9). Furthermore, the material has been ob-