HISTORICAL DEVELOPMENT AND DEFINITION 3 



v. Frankl-Hochwart] and the suprarenal cortex to premature development. 

 Only the thymus gland has not as yet found a secure position in the sympto- 

 matology of the disease of the ductless glands. Finally, the symptomatol- 

 ogy of multiple ductless glandular sclerosis has been more sharply delimited 

 under the multiform syndrome of " insuffisance pluriglandulaire " described 

 by Claude and Gougerot, and from it has been separated the disease picture 

 of isolated late eunuchoidism. 



These few examples may suffice to furnish an idea of the impetus that the 

 clinical aspects of the disease of the ductless glands have assumed in the last 

 decade. The advance in experimental pathology and especially in physio- 

 logical chemistry has really not kept pace with this development of clinical 

 pathology and the extension of pathological anatomy. I do not mean to 

 belittle the significance of what has been brought to recognition through 

 experimental pathology; this alone has made possible the rapid advance of 

 the clinical side; I only wish to say that the deficient knowledge of the 

 chemical nature of the active substances given off by the ductless glands 

 constitutes the weak point in the knowledge of the internal secretions and 

 explains why even to-day we are very often compelled to work with hazy 

 ideas. But even in this direction significant accretions [to our knowledge] 

 are present; we can say that through the isolation and chemical definition 

 of adrenalin (Takamine) and through the knowledge that this body of re- 

 latively simple chemical structure and eminent physiological activity is the 

 specific secretion of the chromaffin system, the foundation stone has been 

 laid for the physiological chemistry of the internal secretions. Experi- 

 mental pathology entered here most opportunely, and acted prominently 

 in the discovery of the manifold actions of this substance and its points of 

 attack on the organs affected by the sympathetic nerves. The isolation 

 of adrenalin, it is known, followed from that of iodthyroglobulin (Baumann, 

 Oswald). In this case, however, slight doubts are still present as to whether 

 we have in iodthyroglobulin the specific internal secretion of the thyroid 

 in purest form. Then, too, we are very much less exactly informed as to 

 its way of action and points of attack. The knowledge of the specific 

 secretion of the other ductless glands is as yet extremely faulty. Of the 

 suprarenal cortex we only know that it contains cholin, a body of con- 

 siderable physiologic activity that is distributed otherwise in the organism. 

 That, however, we have in cholin a specific secretion of the suprarenal cortex 

 is improbable. It has been possible recently to obtain from the lobes of 

 the hypophysis extracts of great physiologic importance that have already 

 secured for themselves a place in therapeutics; but there are wanting the 

 chemical definition and the demonstration that these bodies are given off 

 to the blood. All postulates that we must ascribe to a substance in order 

 that we may regard it as the specific secretion of the ductless gland in question 

 have not as yet been fulfilled by any of the hormones. We must ascertain: 



