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 



