ADDENDUM 49 



In a detailed study Lorand has upheld the idea that the degeneration of 

 the ductless glandular system is chiefly the cause of senility. I would not 

 concur with this, so far as physiological old age is concerned, but believe 

 much more, as does also Ewald, that the ductless glandular system like every 

 other organ participates in the involution of old age. There is, on the other 

 hand, a pathological old age, setting in prematurely or asspciated with dis- 

 tinct accentuation of the cachexia. The premature senility which develops 

 in most of the diseases due to giving out of function, and especially in mul- 

 tiple ductless glandular sclerosis, makes intelligible to me the fact that 

 degeneration in the ductless glandular system may be one of the causes 

 of pathological age. 



Addendum 



With regard to what has been written in toto, it may be said that the 

 author's views respecting the grouping, the reciprocal action, etc., of the 

 ductless glands, and their effects on the various organs and systems of the 

 body, are sound. On the whole they seem to be somewhat in advance of 

 the general conception in America of the purport and scope of the ductless 

 glandular apparatus, at least in regard to their definiteness. There seems 

 to be a tendency among some recent investigators to claim too much for the 

 ductless glandular system and to jump to conclusions, attributing effects to 

 the system of endocrine organs that might just as well be explained by 

 metabolic processes that are general, or that are part of constitutional fac- 

 tors at least one step removed from purely internal secretory activities. 



The author's chapter on ductless glands and constitution has the tend- 

 ency to counterbalance this drift. Here the various ductless glandular 

 constitutional states are considered as part of a "total constitution," which 

 is made of factors that mutually influence each other, including the ductless 

 glandular system. If to the modern mind such an attempt to revive the 

 idea of "constitution" and its sister conception "diathesis" savors too 

 much of the old humoral pathology (which by the way in its serological 

 form has led or will lead to a later chemical aspect of the subject which will 

 perhaps be all-embracing so far as relation between cell and tissue juices is 

 concerned), it must not be forgotten that "constitution" itself represents 

 but one factor of a far more extensive subject heredity, a subject that in 

 its last analysis resolves itself again into factors that are mechano-chemical, 

 and perhaps is part dependent on the activities of just these ductless glands. 



The Abderhalden reaction has already furnished results with regard 

 to the reciprocal activities of the various ductless glands. To the editor's 

 mind it would seem that the importance of the significance of the Abder- 

 halden reaction (in general, not simply the pregnancy test) has not as yet 

 been sufficiently realized, at least in this country. 1 That its basic principle, 



1 Much work has recently been done with the Abderhalden reaction, especially in the field 

 of nervous and mental disease. Remarkably striking have been the labors of Fauser and his 

 followers, in the Abderhalden diagnosis of dementia precox I shall not enter into this matter 

 4 



