Disorders of Metabolism and Inter- 

 nal Secretions in Relation to 

 the Eye 



PEECY FRIDENBERG 



NEW YORK 



Introduction 



Endocrinology is of basic and wide significance for all vital reactions. 

 The processes of heredity, including sex, the rhythm and periodicity 

 of growth and maturity as well as of senescence, are largely controlled by 

 the hormones, although the mechanism and the details of that control are 

 as yet not fully understood. An application of this science to clinical 

 ophthalmology may follow either of two paths. We may compile and 

 codify the data of ocular disease, morphology, and immunity, and note 

 the reciprocal relations with admittedly endocrin states or disturbances. 

 Or, we may attempt to trace back to comparatively uncomplicated bio- 

 chemical reactions both the ophthalmological observations and those con- 

 cerning the glands of internal secretion. This would appear to be the more 

 scientific method of attack at least in any preliminary study hoping, as 

 does this one, rather to map out a field for further investigation than to 

 offer detailed and definite conclusions and suggestion for therapy and 

 diagnosis. Endocrinology influences heredity, morphology, metabolism, 

 immunity, development, function and nutrition, and its application to 

 any special field of medicine must logically relate and refer to one or 

 more of those categories. 



Knowledge of the basic facts of endocrinology has given an entirely 

 new significance to the terms constitutional treatment and systemic dis- 

 ease. We think of it less in terms of complement fixation, mixed treat- 

 ment, plasmodial parasitism, the salicylates, than as dominant dyscrinism 

 adrenal, thyroid, pituitary or combined, with a final clinical picture, as 

 far as symptoms go, of vagotonia expressed in spasmophiliac reactions, 

 or in sympatheticotonia. These can be modified not only by drugs and 

 diet, but by vitamins and hormones, alimentary and emotional regimen, 

 and exercise. This science shows us, further, that all telluric influences, 



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