934 CHARLES E. DE M. SAJOUS 



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is not surprising, therefore, that the man in everyday practice early be- 

 came interested in the internal secretions and strove to value the growing 

 knowledge of the subject for diagnosis and therapy. That he should 

 have made some mistakes is not at all to his discredit. Mistakes are in- 

 evitable in the early application of scientific discoveries to practical medi- 

 cine. The important thing is to learn by our mistakes and to avoid their 

 perpetuation. Mankind has always made progress by the method of trial 

 and error. He who makes no mistakes does nothing. Though not meant 

 literally there is much truth in the aphorism of John Hunter "Don't 

 think, try." It is of course necessary both to think and to try and then 

 to think again. In these processes of thought and trial the general prac- 

 titioner has been always active. Experimental studies always require 

 verification by practitioners of medicine before they can gain lasting 

 recognition. Practice is, and has always been, the crucial test of theory. 



In the brief space allotted to me here I desire to emphasize certain 

 points that bear upon the general practitioner's relation to endocrinology. 

 I shall refer especially to the major endocrin syndromes that are now 

 well established, to the complexity of the so-called multiglandular syn- 

 dromes, to the significance of the balanced activity of the endocrin glands 

 for normal structure and function, to the general practitioner's special 

 opportunities for observation, to the place of hypothesis in endocrinology, 

 and to the justification of the use of endocrin products in therapy. 



2. The Major Endocrin Syndromes 



It is to practitioners of medicine that we owe the recognition and de- 

 scription of at least the majority of the syndromes now known to be en- 

 docrin in origin. I need only refer to Dr. F. H. Garrison's account of 

 the historical development of knowledge concerning the endocrin glands 

 contributed to the present treatise for the proof of this. Addison, Graves, 

 Gull, Marie, Trousseau, and Minkowski, were all practitioners of medi- 

 cine, and their names, owing to the part they have played in the picturing 

 of classical endocrin symptom-complexes, are inseparably connected with 

 the history of endocrinology. 



No attempt to give full descriptions of the major endocrin syndromes 

 shall be given here since these will be found fully elaborated in other sec- 

 tions in this work. It may be, however, of use to the general practitioner 

 if I quickly summarize, in a few paragraphs, the states that are now 

 generally recognized as having an endocrin origin. 



Addison' s Disease and Other Hypoadrenias. The clinical picture of 

 Addison's disease, with its bronzing of the skin, its asthenia, its digestive 

 disturbances, and its anemia, was shown by the great English clinician, 

 Thomas Addison, to be associated with destructive lesions of the supra- 



