INFLUENCE OF THE DUCTLESS GLANDS ON THE REGULATION OF METABOLISM IQ 



different factors as appetite, impulse for movements, etc. On these processes 

 the ductless glands have a considerable influence. We can with great prob- 

 ability, as we shall see later, divide the hormones into anabolic and catabolic 

 (retarding and acceleratory, or assimilatory and dissimilatory) . An im- 

 portant anabolic hormone is, for example, the pancreas hormone, as it is very 

 important for the carbohydrate assimilation and, as I am inclined to assume, 

 also for the fat assimilation. This fact also makes comprehensible an in- 

 fluence of the ductless glandular system upon the regulation of the total ex- 

 change (not the caloric production alone). A fattening, 1 that is, a significant 

 increase in the assimilatory processes, would only then be possible when the 

 ability for it, that is, a certain breadth of function of the ductless glands in 

 question, is present, otherwise the organism would protect itself against the 

 increased supply of food. This seems to throw some light on the obesity 

 associated so commonly with certain ductless glandular diseases. The con- 

 sideration of the fundamental exchange alone would not carry us to the goal, 

 for it is very well conceivable that the fine mechanism of regulation between 

 assimilation and dissimilation is disturbed without an alteration of the 

 activity of the vegetative organs to such an extent as to influence the funda- 

 mental exchange. Only in diseases in which the diminution of the funda- 

 mental exchange is quite clear, for instance in myxedema, must there be 

 added, if obesity is to develop, a disturbance in the relation between assimi- 

 lation and dissimilation, as otherwise the ingestion of nutrition would simply 

 diminish with the lessened need. 



Also in those ductless glandular diseases that according to experience are 

 associated with emaciation must there be present a similar disturbance of 

 the mechanism of regulation, although in the opposite direction. The increase 

 in the fundamental exchange in Basedow's disease can otherwise be vitiated 

 by corresponding increased ingestion of food. Here indeed the relations are 

 very much more complicated, as the ingestion of much food may be made 

 difficult through vomiting or through diarrhea. It seems to me, however, 

 that this explanation is not sufficient for all cases. We sometimes see indeed 

 in this very Basedow's disease a paradoxical relation; in spite of the per- 

 sistence of Basedow's disease, an obesity can develop after initial wasting, and 

 some have seen in this obesity evidence for a dysfunction of the thyroid gland. 



It seems to me very likely that in such cases, in spite of persistence of an 

 increased dissimilation, the assimilatory processes on account of a gradual 

 developing hyperfunction of the pancreas, win the upper hand. On the 

 other hand, emaciation may enter in on account of primary disturbance of 

 assimilation, as is the case in severe diabetes mellitus ; here the gross exchange 

 is increased, the production of calories not however increasing. 



Finally there must be ascribed to the ductless glandular system an influ- 

 ence on the heat-regulation of the animal organism. These disturbances of 



1 Increase in weight due to feeding [Mastung]. Editor.' 



