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The discovery by Hench, Kendall, Slocumb, and Polley (1950) that cortisone has the capacity to reverse the inflammatory reactions of rheumatoid arthritis stimulated great research activity in many disciplines of medicine. Biochemists, physiologists, and physicians, gifted with imagination and skilled in basic research, have contributed a vast body of knowledge about the mechanisms of adrenocortical secretion. The rates, cycles, and pathways of their biosynthesis have been explored; and their disposition and metabolic fates are now known. Much valuable information has also been acquired about the influence of adrenocortical steroids on carbohydrate, protein, and electrolyte metabolism, their effects on the processes of inflammation and immune reactions, their influence on the response of mesenchymal tissues, and their interrelation with the function of other endocrine glands. Simultaneously, resourceful physicians of many lands have been making practical application of corticosteroid compounds as treatment agents in a variety of disease states, including several rheumatic disorders, and have been critically appraising their merits, deficiencies, and hazards.Investigators have been especially active in the chemical development, animal testing, and clinical assessment of chemically modified derivatives of cortisone and hydrocortisone. Research has been channelled in this direction with the aim of determining how alterations in formulae influence biological function, and, if possible, of devising compounds with greater therapeutic efficiency than the natural hormones. Since cortisone and hydrocortisone have serious limitations as treatment agents for rheumatoid arthritis and other chronic

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