HISTOKY OF ENDOCRINE DOCTRINE 75 



"In how far those sudden and violent excitations of the autonomic nervous system 

 which accompany strong emotions are due to the intervention of the glands of internal 

 secretion, and in how far they depend upon direct neural conduction from the brain, 

 we are as yet but ill informed. I need only remind you of the vasodilatation of the 

 face in the blush of shame, of the stimulation of the lacrimal glands which yields the 

 tears of sorrow, of the palpitation of the heart in joy, of the stimulation of the sudorip- 

 arous glands which precedes the sweat of anxiety, of the stimulation of the vaso- 

 constrictors, the pupil dilators, and the pilomotors in the pallor, mydriasis, and goose 

 skin of fright, to illustrate some of these violent automatic excitations. While we do 

 not yet understand the exact mechanisms of association among the activities of the 

 cerebrum, the endocrine glands, and the reciprocally antagonistic autonomic domains 

 and their end organs, we can begin to see the paths which must be followed, in order 

 that more exact knowledge may be gained. 



"The balance maintained normally between the two antagonistic systems is one of 

 the most interesting of physiological phenomena. Think, for example, of the rate of 

 the heart beat how constantly it is maintained at a given level in each individual 

 when the body is at rest ; the impulses arriving through the vagal system just balance 

 those arriving through the sympathetic system, so as to maintain a rate of approxi- 

 mately seventy-two beats per minute. And a similar balance is maintained in other 

 autonomic domains (e. g , pupils, bronchial musculature, gastric glands, gastrointes- 

 tinal muscle, sweat glands, bladder muscle, etc.). 



"This equilibrium is all the more remarkable when one considers how frequently 

 it is temporarily upset in the exercise of physiological function. The play of the 

 pupils with varying light, the watering of the mouth at the smell of savory food, the 

 response of the heart to exercise and emotion, the flow of gastric juice on adequate 

 stimulation, the opening of the bile duct at the call of the chyme, the transport of 

 the colonic contents through one-third of the length of the colon by means of one 

 vehement contraction every eight hours, the sudden relaxation of the sphincter and 

 contraction of the detrusor of the bladder in micturition, the violence of contractions in 

 the domain of the nervus pelvicus in parturition in the female and in ejaculation in 

 the male, come to mind at once as examples of sudden physiological overthrow of bal- 

 ance." 



Another set of correlations advanced by the Vienna school is connected 

 with the causation of diabetes. Eppinger, Falta, and Riidinger regard 

 the thyroid, pituitary, and adrenals (chromaphil system) as the accelera- 

 tors or mobilizers of glycosuria, in that all three increase exchange or 

 metabolism of proteins, the adrenals mobilizing carbohydrates and the 

 thyroid increasing fat absorption. The pancreas and the parathyroids, on 

 the other hand, are held to be inhibitors of glycosuria, retarding protein 

 metabolism and restricting the mobilization of carbohydrates. Diabetes 

 following excision of the pancreas is held to be due to the mobilizing power 

 of the adrenal hormone on the glycogen of the liver, the normal inhibitory 

 action of the pancreatic hormone being removed, and is thus at once a 

 positive adrenal diabetes and a negative pancreatic diabetes. This har- 

 monizes with the glycosurias following injection of adrenalin or following 

 increase of the adrenal function from stimulation of the sympathetic sys- 

 tem. Hyperthyroidism (exophthalmic goiter) produces a tendency to gly- 

 cosuria from relative pancreatic insufficiency and increased adrenal activ- 

 ity. Myxedema or the corresponding removal of the thyroid gland pro- 

 duces an increased tolerance for carbohydrates (obesity), because the 

 inhibitory function on the pancreas is removed and adrenal action dimin- 

 ished., There is a lowering of carbohydrate tolerance after parathyroid- 

 ectomy. The lowered carbohydrate tolerance in hyperpituitarism and the 

 increased tolerance in hypopituitarism, demonstrated by Gushing, is ex- 



