It has been suggested by Selye (1951) and Gray & Ramsey (1957) that the adrenal cortex and centres regulating its function may be involved not only in the physiological control of gastric secretion but also in the aetiology of peptic ulceration. This possibility became of great interest after the introduction of corticosteroids into clinical practice; long-term treatment has been reported to have, as a side-effect, a high incidence of peptic ulcers which are similar to spontaneous ones (Garb, Soule, Bartholomew & Cain, 1965).
Determinations of plasma concentration and urinary excretion of corticosteroids in patients with peptic ulcer failed to detect differences from normal subjects. However, it is likely that the quantitative changes in cortical activity may be too subtle to be shown by this type of test: they may only be demonstrable by following the circadian fluctuations in adrenocortical secretion.
The circadian changes in the plasma cortisol levels were therefore
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