ORGANOTHERAPY AND THE ADRENALS 165 
something to the circulatory fluid, something that is 
merely a product of its own metabolism, to enable only 
itself to live; something that may stimulate or enable 
a distant cell or organ to do its work; something that 
will in some way modify the metabolic equilibrium 
upon which health depends. 
To the internist there is no department of medicine 
of more interest and importance. A very little reflec- 
tion causes wonder at the large number of little chil- 
dren who are not well nourished and robust; at the 
large number of adults pursuing their usual vocations, 
but not well. ‘My neuralgia,” “My rheumatism,” “My 
backache”—familiar words, descriptive of conditions 
more or less cheerfully borne, but borne because the 
patient knows by experience the difficulty of obtaining 
relief. 
Much of our nomenclature is an index of our igno- 
rance, rather than otherwise. How many of us know 
what we mean by “neurasthenia,” “hysteria,” etc? It 
really seems as if we sometimes call the patient names 
in our impatience with him for not being or getting 
well, when our impatience should be with ourselves 
that we really do not know what is the matter with him, 
or how to cure him. 
The attempt to find a rational basis for treatment by 
taking into account the simpler facts of physiological 
chemistry produces astonishment that such things can 
be. Most of our activities lead to the production of acid 
in the tissues (arbonic acid). (Howland Bull, Johns 
Hopkins Hosp., 1916, xxvii, 63), has shown that “this 
stream of acid . . . with an adult, in the course of 
the day, is the chemical equivalent of several hundred 
cubic centimeters of concentrated hydrochloric acid.” 
In addition, there is a large constant elimination of 
acid, urea and other wastes through the kidneys; there 
is the detoxicating action of the liver, the circulation 
of hormones and enzymes, and the many known and 
