The paper by Naeye, et al.,1 in this issue reports a very interesting relation between adrenal gland size and the presence of hyaline membrane disease in newborn infants. Those infants with hyaline membrane disease had smaller adrenal glands than weight matched control infants, due to a decreased number of cells in both the permanent and fetal zones of the adrenal cortex. More direct evidence of possible relation between adrenal cortical size and the capacity of the lung to produce surfactant is brought out by their finding of a correlation between adrenal cortical size in anencephalic infants and the osmiophilic granule content of so-called type II alveolar lining cells.