Endocrine Disorders
1563 CE, anatomical description by Bartolomeo Eustachi, Italy
Addison's disease, a condition resulting from insufficient production by the adrenal glands, carries the name of the Victorian-era physician who first formally described it as a distinct medical entity in 1855. Before Thomas Addison's landmark monograph, the adrenal glands were little understood and widely theorized about, with their function remaining a subject of speculation for centuries after their anatomical discovery. The history of this condition is inseparable from the broader story of how physicians came to understand that small, unremarkable-looking glands perched atop the kidneys were in fact essential to life.
Historical Narrative
The adrenal glands were first described anatomically by Italian physician Bartolomeo Eustachi in 1563, who illustrated them in his anatomical atlas and noted their position above the kidneys. Eustachi had no understanding of their purpose, and for the following three centuries, the glands attracted occasional anatomical curiosity but no consensus about their function. Various theorists proposed that they served as reservoirs for nerve fluid, that they cushioned the kidneys, or that they produced substances carried to the brain — none of which proved correct.
Thomas Addison, a physician at Guy's Hospital in London, published his seminal monograph in 1855 titled 'On the Constitutional and Local Effects of Disease of the Supra-Renal Capsules.' In it, he described a pattern of profound weakness, distinctive skin darkening, and eventual fatal collapse that he had observed across multiple patients at autopsy, consistently finding the adrenal glands to be diseased or destroyed — often by tuberculosis, which was rampant in Victorian London. Addison was careful and methodical, correlating his clinical observations with post-mortem findings in a manner that was exemplary for his era.
The immediate medical community was not uniformly impressed. Some colleagues dismissed the adrenal glands as too small and structurally simple to be truly essential organs. French physiologist Charles-Édouard Brown-Séquard conducted a series of animal experiments in 1856, removing adrenal glands from various species and demonstrating that the animals rapidly died, providing crucial experimental evidence that the glands were not merely decorative anatomy but physiologically indispensable.
William Osler, the enormously influential Canadian physician who shaped North American medical education, reported in 1896 that he had administered crude adrenal extracts to patients with Addison's disease with some apparent temporary benefit — one of the earliest attempts to replace the missing glandular product therapeutically, even before the product itself had been identified.
The identification of what the adrenal cortex actually produced proved to be a decades-long chemical puzzle. George Oliver and Edward Albert Sharpey-Schafer identified adrenaline from the adrenal medulla in 1894, but it became clear that adrenaline alone could not account for survival, since it came from the inner portion of the gland rather than the outer cortex where the real life-sustaining secretions originated.
The painstaking isolation of cortical hormones proceeded through the 1930s and 1940s. Swiss chemist Tadeus Reichstein and American biochemist Edward Calvin Kendall independently worked to isolate and characterize the various steroid compounds produced by the adrenal cortex, work for which they shared the Nobel Prize in Physiology or Medicine in 1950. Their colleague Philip Showalter Hench was included in the prize for demonstrating the dramatic anti-inflammatory effects of cortisone, a discovery that opened entirely new vistas in medicine far beyond Addison's original observations about adrenal failure.
The naming of the disease after Addison, formalized as a tribute by his contemporaries following his death in 1860, represented an unusual honor in Victorian medicine and cemented his place in the history of endocrinology as the physician who first mapped an invisible frontier between an obscure pair of glands and life itself.
Key Historical Figures
Historical narrative only — this page describes how Addison's Disease was understood historically. It is not medical advice and does not describe current diagnosis or treatment. Sourced from verified medical history references (NIH, Encyclopaedia Britannica, and standard medical history texts). See our medical disclaimer.