Dysentery (q.v.) is another war disease, and there were many cases among the troops at Gallipoli and elsewhere in the East. There is more than one kind of dysentery. One of them, amoebic dysentery, is prone to be followed by liver abscess, the amoeba passing to the liver. Before the War it was found that emetine, an alkaloid of ipecacuanha which had been long known as an empiri cal remedy for dysentery, was extremely efficient in curing this form of dysentery and also the hepatitis or inflammation of the liver which precedes the formation of an abscess.
As a result of the large numbers of officers and men who suffered from war strain and its effects, often called shell-shock, during and after the War, the psychotherapy of these nervous disorders has greatly developed (see PSYCHOTHERAPY). Endocrine Therapy.—When any of the endocrine glands, the thyroid, adrenals, pituitary, which pour an internal secretion into the blood and keep the body in health, are diseased or fail to do their work properly, signs of disorder or disease result. The secre tion may be suppressed or diminished, excessive or altered in char acter (see ENDOCRINOLOGY). When the secretion is diminished an attempt tc provide it can be made, and in the case of thyroid, which when inadequate produces myxoedema, or in early life cretinism, brilliant results have long been obtained by this substi tution therapy of giving the thyroid gland or an ,extract of it by the mouth. In 1914 E. C. Kendall of the Mayo Clinic, Rochester, Minnesota, obtained in a pure form the active principle—thyroxin —which is extremely effective. The parathyroid glands, small bodies close to the thyroid gland in the neck, manufacture an in ternal secretion which passes into the blood and exerts an action apparently opposed to that of the thyroid. Whereas the thyroid is concerned with the control of iodine in the body, the parathy roids deal in a similar manner with calcium salts. Deficiency in the action of the parathyroids appears to lead to a diminished quantity of calcium salts in the body and to an irritable state of the nervous system, and is thought to be responsible in children for the contracture of the hands and feet known as tetany, though on this question there is considerable discussion. Recently the ex
tract of the parathyroid glands has been given in a number of diseases of a chronic infective nature, especially in sprue (see SPRUE), a tropical disease characterized by diarrhoea, want of digestion of food so that the patient wastes as if from starvation.
An outstanding advance in organotherapy is the insulin treatment of diabetes mellitus (see DIABETES). In this disease the patient, who is unable to utilize sugar and starches, passes sugar in the urine, wastes and may eventually die in coma. The pancreas, or sweetbread, is a gland concerned with the digestion of food, including starches, in the alimentary canal, and at the same time that it provides this external secretion pours an internal secretion into the blood which enables the body to make use of sugar. This internal secretion is manufactured by structures in the pancreas known as the islands of Langerhans, and the extract from them is called insulin. After many trials the technical difficulties in obtaining a satisfactory insulin (see IN SULIN) were surmounted in 1922 by F. C. Banting and C. H. Best of Toronto, and a remedy was thus made available, which though it does not cure diabetes, any more than the thyroid extract cures myxoedema, yet for some hours makes the previous dia betic practically a normal person as regards the utilization of starch and sugar. The hypodermic administration of insulin must be repeated at least once daily, but this treatment keeps the dis ease in abeyance and has thus prolonged and saved innumerable lives. In diabetes insipidus, a comparatively rare disease, in which large quantities of urine free from sugar are passed, relief for some hours is similarly obtained by hypodermic injection of extract of the posterior lobe of the pituitary gland. The success of thyroid and insulin treatment has stimulated research and trial in the case of other glands and numerous commercial preparations have been placed on the market ; but the claims sometimes made for various forms of organotherapy have yet to be confirmed. The most re cent is the treatment of pernicious anaemia by feeding with liver. This method was introduced by Minot of the Rockefeller Institute and the success he claims for it has been confirmed in England.