Physicians who treated John F. Kennedy, and examined his body after his death, have confirmed that the 35th president had Addison's disease, a chronic illness that was the subject of much rumor and disinformation during his lifetime.

Kennedy was being treated for Addison's disease when he had back surgery in 1954, a member of the surgical team told the editor of the Journal of the American Medical Association (JAMA), according to this week's issue of the publication. Furthermore, one of the pathologists at the assassinated president's autopsy confirmed that virtually no traces of the adrenal glands were found, the journal said.

The rare illness, which is fatal if untreated, was an open secret during Kennedy's campaign for the presidency and term in office. Nevertheless, political associates, some family members and Kennedy himself denied he had the disease, which was apparently first diagnosed in 1947 or 1948.

Several historians have noted that any association of the youthful president with a serious, chronic illness would have been viewed as a political liability. Consequently, mention of the subject was often clouded by largely semantic arguments that he did not have "classic" Addison's, that he merely had an "insufficiency" of adrenal hormones, or that -- because he was being successfully treated for it -- he didn't have the illness at all.

The subject arose in JAMA's third article this year on the Kennedy assassination and autopsy. Earlier reports concluded that the president was struck from behind by two bullets, disputing conspiracy theories that more than one gunman was involved.

The journal this week contains an interview with Pierre Finck, one of three pathologists who performed a post-mortem examination of the president at the Naval Medical Center, in Bethesda, the night of the assassination. Finck, who now lives in Switzerland, concurred with the two other pathologists -- whose interviews were published in May. But he refused to comment whether the president's adrenal glands were found to be diseased.

A confirmation of Addison's disease came from a third pathologist who was present at the autopsy. George D. Lundberg, JAMA's editor, says in an editorial that J.T. Boswell, one of the other pathologists, confirmed to him in August that no adrenal glands were visible and that microscopic exam of where they should have been revealed "only a few individual . . . cells."

Lundberg wrote that he also confirmed the longstanding rumor that a patient with Addison's disease described in the journal A.M.A. Archives of Surgery in 1955 was Kennedy, then a freshman senator from Massachusetts.

"Case 3" in the article describes the experience of "a man 37 years of age {who} had Addison's disease for seven years . . . Owing to a back injury, he had a great deal of pain which interfered with his daily routine."

The patient underwent spinal fusion at the Hospital for Special Surgery, an affiliate of Cornell University Medical College, in New York City, on Oct. 21, 1954. The focus of the report was the complicated regimen of hormones and intravenous infusions used to treat the man's adrenal disease.

Major surgery on patients with Addison's disease was -- and is -- considered risky, even when they are treated with hormone replacement. Kennedy, in fact, had numerous post-operative complications and was twice administered the last rites of the Roman Catholic church.

Those complications, which included two serious infections, may have been indirect consequences of his disease, though the doctors who described his case noted he never had "Addisonian crisis," an often fatal collapse of the circulation that comes from having inadequate amounts of adrenal hormones at times of stress.

JAMA confirmed Kennedy's identity with James A. Nicholas, one of the authors of the 1955 case report. Neither he nor Boswell, the autopsy pathologist, could be reached for comment.

There are two adrenal glands, one sitting atop each kidney. They produce more than half a dozen hormones, though the most important are cortisol and aldosterone. Cortisol acts to ensure that even between meals the bloodstream has enough glucose, a form of sugar essential to brain function. Aldosterone prevents the body from losing large quantities of sodium, a mineral necessary to maintain blood pressure and volume.

Animals whose adrenal glands are removed experimentally may live for brief periods but invariably die when confronted with a physiological stress, such as infection or surgery. Under those conditions, the body must produce up to 10 times the normal amount of adrenal hormones per day in order to survive.

Adrenal insufficiency was first described by Thomas Addison, an English physician, in 1855. Patients were thin and weak, had characteristic low blood pressure, anemia and tan skin. On autopsy, the size of their adrenals was greatly reduced, and there was often evidence of tuberculosis infection in the glands.

Physicians now know, however, that Addison's disease usually occurs without evidence of infection. It is presumably the result of autoimmune disease, in which antibodies attack and destroy the gland. The JAMA article noted there was no evidence of TB in the remnants of Kennedy's adrenals.

Treatment today consists of daily replacement with adrenal hormones, usually cortisol or prednisone, for the glucose-restoring function, and often also fludrocortisone, for the sodium-restoring function. Today, people with Addison's can expect to lead healthy, normal lives.

In the late 1940s, when Kennedy apparently developed the disease, treatment consisted of the implantation of pellets containing desoxycorticosterone -- a weak adrenal hormone -- under the skin every three months. In 1949, cortisone was first used, and in 1950 cortisol was synthesized, paving the way for treatment that nearly mimics natural function of the glands.