Some years ago I was asked by a family doctor to visit a 69 year old man at home to take a history and carry out a physical examination and to perform an electrocardiograph to rule out myocardial infarction after an episode of chest pain the previous day.

The patient said that 50 years previously, he had been told that he had Addison's disease, but when I asked him about drugs he looked at me blankly and said that he had never heard of cortisol or steroid replacement therapy: “No, doctor, in those days there was no …