Endocrinology

“ The amount of fat deposited under the skin, for instance, is influenced by the pituitary, the thyroid, the pancreas, the liver, the adrenals and the sex glands. Other qualities, likewise, are resultants of a compromise between all the endocrine factors comprising the equation of the individual. If we are to look for unit factors at all in endocrine heredity, we must look more deeply into constitution, and measure the hormone potentials and their mobilization or suppression. ”

“ Studying endocrine traits of physique, life reactions, disease tendencies, hereditary history and blood chemistry, one may gain an insight into the composition or constitution of an individual. The endocrine type of an individual is a summary of these, his behaviour in the past, and is also a prediction of his reactions in the future, much as a chemical formula outlines what we believe to be the skeleton of a compound substance as deducible from its properties under varying conditions. ”

“ But we know that the endocrines rule over growth and nutrition, a vast dominion which incorporates every organ and every tissue. By enhancing or retarding the nutritional changes, the growth of the organ or tissue is favored or restricted. The size and shape of an individual, as a whole, as well as of the specialized cell masses composing him, as hands and feet, the nose and ears, and so on, are therefore controlled by them. Whether an organism is to be tall or short, lean or corpulent, graceful or awkward, is decided by their interactions. ”

“ What we know of the endocrine factors in heredity leads us to suppose that it is the mating of one marked endocrine insufficiency with another that is often responsible for the inherited tendency to feeble-mindedness and insanity. The effect of the hormone system upon the vegetative apparatus may create the more obscure insanities and quasi-insanities. The direct action of the internal secretions upon the brain cells, producing a sort of hair trigger situation within them, may cause the explosive discharges from them which appear as overpowering impulses or uncontrollable conduct. ”

“ The control of sugar mobilization from the liver, where it is stored as glycogen or animal starch, is divided between the pancreas and the adrenals, the pancreas acting as the brake, the adrenals as the accelerator of the mechanism. Adrenal and pancreas are therefore direct antagonists, the pans of the scale which represents sugar equilibrium in the organism. Diabetes may be regarded as a disturbance of the adrenal-pancreas balance, assisted by events which produce adrenal overwork like great or prolonged emotion, or by strain of the pancreas, effected by over-eating for example. ”

“ Endocrine types have other tendencies, which when studied and controlled, will decimate the great assassins of middle age: heart disease and kidney disease, with accompanying degenerations of the blood vessels and circulation. The adrenocentric tends to get up a hyperacidity of the stomach and a high blood pressure, besides certain forms of diseases of the lungs. The thyrocentric is predisposed to heart disease, as well as intestinal disturbances. The pituitocentric is liable to periodic and cyclic upsets in his health. ”

“ As in chemistry and physics, so in the science of living creatures there have been recent advances that have changed the whole prospect. A good instance is afforded by the discovery of the "hormones," or chemical messengers, which are produced by ductless glands, such as the thyroid, the supra-renal, and the pituitary, and are distributed throughout the body by the blood. ”

“ The increased action of the muscles of the heart and the blood-vessels increases the efficiency of the circulation; the secretion of the adrenal gland causes a rise in the blood-pressure; the increased action of the thyroid gland causes an increased metabolic activity; there is evidence that glycogen is actively called out, this being the most immediately available substance for the production of energy; the increased activity of the respiration is needed to supply the greater need of oxygen and the elimination of the increased amount of waste products ”

“ More and more we are forced to realize that the general form and external appearance of the human body depends, to a large extent, upon the functioning, during the early developmental period, of the endocrine glands. ”

“ Fatigue as an endocrine deficiency—a depressed state of one or more of the glands of internal secretion, abolished when its normal functioning is restored—is a general principle from which departures of exploration of sub-problems will proceed. An endocrine organ will secrete at a certain rate. When it is stimulated excessively, it will eject extra amounts of its secretion. How long the period of excessive stimulation may last must depend upon the secretion potential or margin of reserve of the cells, varying from organ to organ, and from individual to individual. ”

“ CHAPTER XIII THE EFFECT UPON HUMAN EVOLUTION The ubiquitous and deep-seated influence of the internal secretions upon life and personality comprises but a fraction of what is known, and only a hint of what is to become known. There is an endocrine aspect to every human being and every human activity, normal and abnormal, internal process and its external expression, regulated by laws of which we are beginning to catch a glimpse. ”

“ Recent research advances have included the synthetic production of purified human insulin to ensure adequate supplies of this essential hormone, the development of improved methods for insulin administration, new technologies for monitoring critical blood sugar levels, new therapies for the treatment of diabetes-related kidney, eye, and cardiovascular diseases, and improved clinical capabilities for reducing the increased perinatal morbidity and mortality associated with diabetic pregnancies. ”

“ Metabolism and excretion and the rates of metabolism and excretion can be affected by age, diet, general health status, race, and other factors. In general, the metabolic products will be more water soluble than the parent chemical. Where metabolism yields more than one product, the relative amounts of each and the parent-metabolite ratios are affected by an individual's general health status, diet, genetic makeup, degree of hydration, time after exposure, and other factors. The kidney is the major organ of excretion and is the primary route for water-soluble substances. ”

“ For while the nonliving act upon the endocrines directly, the living act upon the vegetative system, as a whole. The non-living factors are those with the intimate scrutiny of which physics and chemistry have busied themselves: food, water, air, light, heat, electricity, magnetism. The living are the animals that prowl all over the planet, the predatories spreading the gospel of fear.
The dietetic habits of a person, for instance, are known to have an influence upon the glands of internal secretion. Meat-eating produces a greater call upon the thyroid than any other form of food. ”

“ Rapidly he sketched what he had already told me of the thyroid and the hormones. “These hormones,” added Kennedy, “are closely related to many reactions in the body, such as even the mother’s secretion of milk at the proper time and then only. That and many other functions are due to the presence and character of these chemical secretions from the thyroid and other ductless glands. It is a fascinating study. For we know that anything that will upset—reduce or increase—the hormones is a matter intimately concerned with health. ”

“ CHAPTER X THE TYPES OF PERSONALITY THE ENDOCRINE PERSONALITY If a single gland can dominate the life history of an individual it becomes possible to speak of endocrine types, the result of the endocrine analysis of the individual. ”

“ There is every reason then for believing that the white man possesses more of pituitary, adrenal, gonad, and thyroid internal secretions as compared with the yellow man or black man. And since these endocrines control not only physique and physiognomy, anatomic and functional minutiae, but also mind and behaviour, we are justified in putting down the white man's predominance on the planet to a greater all-around concentration in his blood of the omnipotent hormones. ”

“ A man's nature is essentially his endocrine nature. Primarily, when he is born, he represents a particular inherited combination of different glands of internal secretion. They, constituting the inventory of his vital stock in trade, start him in life. Afterwards, food, the routine of his existence, the accidents of experience, education, disease and misfortune, in short, environment, modify him because they modify his ductless glands and his vegetative apparatus, as well as his brain, depressing some parts, and stimulating others, and so rearranging the system. ”

“ Among these pristine factors determining the content of consciousness, the endocrines are most important, because they alone to start with, of all the other factors, are different in each and every individual. ”

“ The hospital management of a case of diabetes is not complete until the patient can live a healthy life in spite of his disease. He may arrive at the hospital in a state of coma and be dragged from the very jaws of death with insulin, but afterwards, when he goes home, unless he has learned how to continue the use of insulin and combine with it an accurate diet, he will slip again into the same dangerous predicament. ”

“ But life episodes and crises, diseases, accidents, and struggles, experiences of pleasure and pain, as well as climatic factors, settle finally which endocrine or endocrines are left in control as a consequence of the series of reactions the period of maturity may be analyzed into. ”

“ In the chapter on historic personages analyzed from the endocrine viewpoint, we shall see that some of the most eminent and illustrious people of history have been pituitary-centered.
MENTAL DEFICIENCY Natural ability grows in an endocrine soil of a particular kind, perhaps affected by the internal secretions much as natural soil is by fertilizers like phosphates or nitrates. Increased production follows increased fertilization. Natural disability must vary similarly with a perversion or improper mixture, deficiency or absence of the hormones that combine in natural ability. ”

“ Upon the basis of these structural, functional and mental differences, the qualitative and quantitative evolution of which in the race as in the individual is guided by the glands of internal secretion, Keith presents a very good case for the view that the white man is an example of relative excess of the pituitary, thyroid, adrenal and gonad endocrines. ”

“ When a diabetic, old or young, goes into coma, he rarely comes out of it, no matter what the treatment is.
Case 10. H. S., male, 6 years, entered April 29, 1915. Duration of his diabetes uncertain; not discovered until day of entrance. An emaciated, frail looking boy. He would eat very little at first, and on ward diet, containing 31 grams of protein, 73 grams of carbohydrate, and 20 grams of fat, he excreted 5.7% of sugar, with a moderate amount of acetone, and a very slight trace of diacetic acid. ”

“ Why not do the same with diabetes? We have seen that overeating is the common cause. Let us, therefore, teach the virtues of keeping lean and fit. Incidentally, such teaching may help to control other chronic diseases. There is reason to believe that heart trouble, high blood pressure, gallstone and cancer, occur in the obese with greater frequency than in the lean. Obesity is a mark of long continued functional overstrain of all the organs of the body. ”

“ Under pressure my body reacts, preparing me to fight or flee. My adrenals pump hormones into my bloodstream, stimulating my heart and my sympathetic nervous system, making glucose more available to my muscles. ”

“ Thus far we have spoken of hormones only in connection with their ability to excite those nerve cells by which smooth muscles and glands are controlled. As a matter of fact, their action is much wider than that. They have the power of affecting the metabolism of very many body cells. Some of them appear to have the special function of regulating the rate of metabolism. These we shall talk about in detail, when we return to the study of metabolism in a later chapter. One of the hormones is interesting in connection with the relation of emotions to smooth muscle and gland activity. ”

“ Sajous, believing that insufficiency of the adrenal secretion is an element in altered nutrition, advocates thyroid extract on the ground that it stimulates the activity of the adrenals: Vincent quotes Erlich as believing that “there may be substances circulating in the organism which may stimulate the body cells to resist the athreptic influence of cancer cells.” ”

“ As already intimated, we do not know just why in some persons and at a certain time a disturbance of metabolism results in perverted cell growth, but there is, of course, a reason, and the physician’s duty is so to regulate the patient’s whole life that the metabolism is kept in the state of perfect health. ”

“ Diabetes represents the absence from the body, probably as the result of disease, of certain substances which are responsible for the control of the digestion and use of sugar, and insulin cannot restore these tissues or substances any more than the injections of other glands can restore youth to the aged. ”

“ The nutrition and activity of the myocardium can be increased and sustained by means of specific cardiac stimulants and tonics, such as strychnine, ammonia and the digitalis group of drugs; by hæmatinics, stomachics and laxatives to afford an abundant supply of healthy blood; by insuring wholesome nervous influences, one of the conditions of hypertrophy; and by the employment of the non-medicinal measures now so extensively used to increase the vigour and benefit the metabolism of the cardiac walls, particularly active and passive exercises and baths. ”