THE IMPORTANCE OF ENDOCRINOLOGY 943 



7. Use of Endocrin Products in Therapy 



The general practitioner is the agent 011 whom we must rely for the 

 majority of observations upon the effects of endocrin products in therapy. 

 Too often, however, he is not sufficiently critical in his judgment of the 

 effects provoked. There is no field in medicine, perhaps, in which one 

 can be more easily deceived. A man with the best scientific training, 

 with the keenest powers of observation, and with strong critical tendencies, 

 may easily be misled in his judgment of the effects of the remedies he 

 uses in the treatment of disease. And if this be true, it is evident that 

 the man of poorer training, or one who observes inaccurately or is non- 

 critical, will much more often be led to false conclusions. We must, how- 

 ever, work with the natural endowments we have, with the particular 

 training we have received and with the critical powers that we possess; 

 and, though we shall all make many mistakes, advances will, I feel sure, 

 gradually result from the endeavors of conscientious workers in general 

 practice. 



The effect of thyroid substances, of hypophyseal substances, of supra- 

 renal substances, of gonadal substances, and the like, are now being 

 watched by practitioners, not only in disorders of the endocrin glands but 

 in other diseases. In recent years it has been possible to work with single 

 substances that have their origin in the endocrin glands, notably with 

 adrenalin (or epinephrin), with pituitrin, and with thyroxin. One of 

 these substances has already been made synthetically, and doubtless, be- 

 fore long, through the untiring activities of biochemists and pharmacists, 

 we shall be supplied with a large number of the synthetic chemical sub- 

 stances that the endocrin glands produce. 



Studies of the effects of epinephrin in normal and abnormal states 

 have already become very numerous, and the effects of this compound upon 

 the various functions of the body are becoming ever better understood. 

 I need refer only to the use of epinephrin in bronchial asthma, in local 

 anesthesia along with novocain, in heart failure, in arterial hypotension, 

 in senile pneumonia and in the hypoadrenias of various infections to il- 

 lustrate how important may be the results of the study of the therapeutic 

 effects of a single chemical compound of endocrin origin. 



The influence of pituitrin upon the uterine contraction during or after 

 labor, upon the intestinal contraction in dynamic ileus, upon the excretion 

 of urine in diabetes insipidus illustrate this action. 



The remarkable influence of Kendall's thyroxin as an accelerator of 

 metabolism not only in hypothyroid states but in other morbid states as 

 well as in normal conditions is another striking instance of the way knowl- 

 edge can be advanced by the isolation in purer from of an endocrin 

 product. 



