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The cortex is a really important part of the adrenal glands. This is shown by the fact that the medulla can be cut out of animals without apparent hum. To cut out the cortex would kill the animal. (Of course, laboratory -animals live quiet lives in cages. They don’t have to face many emergencies and so don’t require much adrenaline).

What is Cortex?

The word “Cortex” comes from a Latin word meaning “bark” because it surrounds the medulla Re the bark of a tree. The hormones it produces are called CORTICOIDS.

CORTICOIDS

There are a great number of these. Twenty-eight different corticoids have been obtained in pure form -and many more probably remain to be isolated.

All the corticoids have similar chemical structure. Unlike the various hormones we have mentioned so far, they are not proteins or amino acids. The corticoids are steroids.

We mentioned steroids, you will remember, when we were, talking about Vitamin D and cholesterol. Steroids have molecules in which the carbon and hydrogen atoms are arranged into four connected rings.

Attached to these rings are Other carbon atoms, and, occasionally, oxygen atoms. All steroids have at least one oxygen atom. Cholesterol, which occurs !so frequently in the body, has just one oxygen atom in its molecule. It also has 27 carbons and 46 hydrogens.

Why Cortex is Important?

The corticoids generally have more oxygens and fewer carbons and hydrogens than that. For instance, the molecule of a typical corticoid would have 5 oxygens, only 21 carbons, and only 27 hydrogens.

The different corticoids have somewhat different jobs to do in the body. On the whole, though, they fall into two groups. One group of corticoids acts to control the level of minerals in the blood.

Cortex

The second group supervises the storage of glycogen in the liver. It makes sure that our supply of this starch-like energy-containing substance is adequate (provided, of course, that we are not starving to death).

Chemists have fancy names for these two groups of Corticoids, but we can call them the MINERAL CORTICOIDS and the STARCH CORTICOIDS.

The two best-known Corticoids are DESOXYCORTICOSTERONE and CORTISONE. The second name is all right but the first one is a real mouthful. Don’t try to pronounce it.

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Even chemists have to fall back on the old trick of using initials. Everyone calls it DOC. perhaps you have heard of one or the other of these. Both are much in the news lately as “wonder drugs.” They represent the two different groups of corticoids. DOC is a mineral corticoid and cortisone is a starch corticoid.

Sometimes a person’s adrenals stop working, just as islets of Langerhans stop working in people with diabetes. in the Case of out-of-order adrenals, the condition is called ADDISON’S DISEASE. If a Combination of DOC and cortisone is used, a patient with Addison’s disease can be kept going.

Cortisone has received most publicity in the newspapers and magazines because it is useful in a disease of the joints called ARTHRITIS.

How Cortex Work

A body’s joints are places where two bones meet. When you bend your arm at the elbow, the bones of the forearm and the bone of the upper arm rub against one another.

This takes place easily and without trouble just as a door turns on its hinges. In the case of a door-hinge, metal rubs against metal as the door moves. To keep the motion smooth, the metal must be smooth where the two surfaces meet. In addition, it is usual to put a little oil on the hinge to cut down friction.

Cortex

The body uses the same system in the case of the joints. Where bone meets bone, the surfaces are very smooth. In, addition, the joints contain a liquid known as SYNOVIAL FLUID, which acts to cut down friction.

Now you know what happens to a door when its hinges gradually lose their oil. It becomes harder to open and when it does move, it squeaks. If the hinges get rusty, so that its surfaces become rough, the moving is still more difficult and the squeaking can be horrible indeed.

In one kind of arthritis, the synovial fluid loses its lubricating powers. Joints become painful. For some reason, cortisone seems to improve the conditions of people with this type of arthritis. It has received a lot of attention for this because before this was discovered no cure was known for this very painful disease.

Hormones

Another hormone which is helpful in arthritis is ACTH. You will remember that this is one of the pituitary hormones. Actually, it is the particular one which orders the adrenal glands to get busy. So you see it amounts to the same thing. ACTH simply gets the adrenals to produce more cortisone of their own, instead of relying on a cortisone supply from outside.

Cortisone is another example of a “wonder drug” that must be used cautiously. If you just read the newspapers, you might get the idea that wonder drugs are as safe as aspirin. You might think that you only have to swallow a few pills and you can cure anything. If you still feel bad, you can swallow a few more. This is not so.

We already know that antibiotics can be poisonous if too much is taken. What’s more, some, people are more sensitive to them than others are. Cortisone is even trickier.

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Being a hormone, it is one of the body’s executives. One of the things it can do is to affect body chemistry in such a way that the troubles of arthritis are cut down.

But what other effects are these changes in body chemistry bringing about? We can’t be sure that they aren’t making trouble in another direction. For instance, some doctors have reported that when cortisone is used on patients with tuberculosis, tuberculosis gets worse.

Also, mice who are given cortisone seem to catch infantile paralysis more easily.

If you sometimes wonder why druggists won’t sell you certain drugs without a doctor’s prescription, you should think of things like this.

Cortex

It is interesting to remember that there are two kinds of hormones. On the one hand, we have the protein hormones and on the other, the steroid hormones.

These are the only two kinds. Why should that be? Again, chemists can only guess. Remember that in the previous chapter we mentioned a theory that hormones did their work by sticking to the cell membrane and changing its properties.

Well, we said that the membrane was composed of proteins and of fat-like substances. It could be (this is only a theory) that the protein hormones act mainly on the protein part of the membrane. The steroids, which are soluble in fats, would act mainly on the fat-like parts.

Chemists are very interested in just how the body manufactures its steroid hormones. They haven’t learned many details yet. It seems quite certain that they are manufactured out of cholesterol, the body’s most common steroid. Also, the adrenal cortex is very rich in Vitamin C.

Steroid Hormones

When the cortex is busy putting out a particularly large batch of corticoids, it gets low in Vitamin C. Exactly what the Vitamin C has to do with it, we don’t know, but it’s a good example of how all the chemistry in the body hangs together.

If we did know exactly how to make corticoids, it would be of great help to medicine. It wouldn’t be so expensive to use cortisone for arthritis, for instance. As it is, we have to obtain a large number of adrenal glands from cattle in the stockyards.

From these, after much tedious work, we can extract a few crystals of cortisone. No wonder it is expensive.
Lately, a completely new technique is being tried. Adrenal glands from animals are carefully removed and the blood vessels are kept filled with blood so that the glands are nourished and remain alive.

The technique is a difficult one and requires complicated equipment. The main point, however, is that the adrenal’s chemical factory is kept working. This process of keeping a part of the body alive by circulating blood through its vessels is called PERFUSION.

Naturally, the blood has to contain oxygen and sugar and whatever else the organ needs.

If now we add to the blood which is circulating through the adrenals some steroid, which is fairly easy to obtain, the adrenals change it somewhat into another one. Sometimes the changed steroid that comes out the other end is quite a valuable one.

Perhaps someday in the future, we can have large factories in which perfused organs of all sorts may be manufacturing many complicated chemicals which can only be obtained now with great trouble and expense.

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