ENDOCRINOPATHIES. Diseases or disorders of growth or adjustment due to dis turbances of the endocrinous glands, or glands of internal secretion. The early mechanistic conceptions concerning the push that lies be hind the metabolism of the human body have slowly and gradually undergone modification until the importance of a number of overlooked structures has forced itself, almost with a whirl, upon the medical horizon. These structures are the endocrinous glands. The study of their anatomy and functional import ance now constitutes an enormous specialty.
As early as 1828 Parry called attention to the relationship between enlarged thyroid and increased frequency of the heart beat (tachy cardia), since which time the works of Jo hannes Muller, Addison, Gull, Brown-Sequard, Marie and many others have served as start ing points for the building up of a rich struc ture which is amply recorded in a score of monographs. The chief of these are Biedl, 'Internal Secretions' (bibliography of 4,000 titles, 1913); Falta, 'Ductless Glands' (1915) ; Parhon et Golstein, 'Les Secretions Internes' (1909); Levy and Rothschild, (Endocrinologie' (1913) ; Gley, 'Les Secretions Internes' (1914); Sajous, 'Internal Secretions' ; special articles in Lewandowsky's (Handbuth der Neurologie' (1913), and Jelliffe and White, 'Diseases of the Nervous System' (2d ed., 1917).
Out of this prodigious development to be found in the works just cited and in current medical literature, much of which is evanescent and hastily constructed, a large amount of solid substance remains and a number of permanent acquisitions have been made. The net result has been to show much more essentially than ever before the fundamental physicochemical foundations of biological metabolic processes as they are utilized in the upkeep of the animal machine. The viewpoint has been attained that a marked degree of chemical interrelationship takes place between the different organs of the body. That this is automatically regulated through the vegetative nervous system (the old sympathetic) chiefly, apparently in some cases, though this is by no means clear, solely through chemical regulation. The disorders of this ad justment now constitute a special department of vegetative neurology, and are most conveniently grouped under the terms endocrinology, or the endocrinopathies.
In the earlier period of the study of these endocrinopathies individual disease groups, uni glandular syndromes, were isolated. Among the most accentuated of these were Addison's dis ease, diabetes mellitus, myxedema, cretinism and acromegaly; but of recent years it has been increasingly emphasized that whereas a certain group of symptoms, which may be linked to plus or minus activities of one or another gland may be most prominent, nevertheless other glandular modifications are bound up in them and are not to be neglected. Hence has arisen the viewpoint that•most of the endocrin opathies are, strictly speaking, poly- or pluri glandular syndromes, that is, that disease or maladjustment in one gland usually induces compensatory changes in other glands.
For many years, even back to the earliest days of primitive animistic magic, it has been held that every living tissue yields a chemical product which will act upon other tissues. The early alchemistic studies, those of Paracelsus, to the later work of Hahnemann, and the iso therapists, are all attempts to co-ordinate a host of empirically observed facts. They are all worth rereading if the reader will put himself in sympathy with them through a comprehen sion of the now strange symbols then used.
Endocrinous glands for the present purposes are those structures which yield products termed hormones and chalones having some definite or specific action related to, yet different from, enzyme activities. These structures are developed from different embryological forma tions. The hypophysis (posterior lobe) and chromaffin tissues (suprarenal chiefly) are nervous the thyroid and pituitary (anterior lobe) come from the buccal cavity; the pan creas and mucosa of the small intestine from the intestine, the parathyroids and thymus from the branchial arches (old gill slits of fishes), the gonads (testes and ovary) and the inter bodies from the genital ridges. Some of these, in humans, merge into one structure, as thyroid and parathyroid, as chromaffin and in terrenal cells in the suprarenals, as hypophysis (posterior lobe) and pituitary (anterior lobe).