August 6, 1915] 



SCIENCE 



169 



bodies of other congenital myxedematous 

 children of this class. 



Further illustrations were then given by means of 

 lantern slides of endemic cretinism and goiter and it 

 was shown by statistics and by a map of Europe 

 that these abnormalities have very great economic 

 significance, on account of their great prevalence in 

 certain parts of central and western Europe and to 

 a less degree in our own and other countries. For 

 instance, in Switzerland one sixth of the male pop- 

 ulation is unfitted for military service by cretin- 

 ism in some degree.27 



After even these few illustrations of ab- 

 normalities that follow on removal or dis- 

 ease of these glands, I think you will agree 

 with me that my colleague, Professor 

 Barker, has not exaggerated their impor- 

 tance when he says. 



More and more we are forced to realize that 

 the general form and the external appearance of 

 the human body depend to a large extent upon the 

 functioning, during the early developmental 

 period (and later), of the endocrine glands. Our 

 stature, the kinds of faces we have, the length of 

 our arms and legs, and the shape of the pelvis, the 

 color and consistency of our integument, the quan- 

 tity and regional location of our subcutaneous fat, 

 the amount and distribution of hair on our bodies, 

 the tonicity of our muscles, the sound of the voice 

 and the size of the larynx, the emotions to which 

 our exterieur gives expression — all are to a cer- 



-" ' ' Der Kretinismus, ' ' H. Vogt, in Handtuch 

 der Neurologie (Lewandowsky), Vol. IV., Spe- 

 zielle Neurologie, III., p. 139. Here also it is 

 stated that the three Italian provinces. Piedmont, 

 Lombardy and Venice had 120,000 cases of goiter 

 and 13,000 cretins in 1883, the total population of 

 these provinces at that time being 9,400,000. In 

 1908, according to Biedl, Austria had on the 

 average 64 cretins to every 100,000 of the popu- 

 lation. In 1873 France had 120,000 cretins in 

 Savoy, the Maritime Alps and the Pyrenees. It 

 will be seen that the thyreopathies constitute a 

 heavy drain on the resources of European people. 



Pictures of persons suffering from other dis- 

 orders, as exophthalmic goiter, acromegaly or 

 giantism and parathyroid tetany, were also given 

 with a brief statement of the glandular and gen- 

 eral nutritive changes involved. Animals such as 

 the monkey, the dog, the rat and others are like- 

 wise subject to disease of this gland. 



tain extent conditioned by the productivity of our 

 hormonopoietic glands. We are simultaneously, 

 in a sense, the beneficiaries and the victims of the 

 chemical correlations of our endocrine organs.^s 



I can not here take up questions of thera- 

 peutics in this interesting field. I can only 

 say that aside from surgical intervention 

 and the brilliant results of thyroid treat- 

 ment in cases once utterly hopeless, we have 

 little to offer that has been positively estab- 

 lished. Nor shall I attempt to discuss the 

 interrelationship of these glands. It has 

 become increasingly evident that to touch 

 one of them is to touch all. Various writers 

 have endeavored to express this interrela- 

 tionship in a series of charts or diagrams. 

 Of these diagrams D. Noel Paton has well 

 said r" 



They may well be a grotesque parody of what 

 will ultimately be found to be the relationship of 

 the activities of these organs. They are prob- 

 ably as near the truth as those quaint ancient maps 

 of the Indies with their "here be gold" scrawled 

 across them which served as the charts of our 

 forefathers, and if, like them, they merely indi- 

 cate the direction which further investigation 

 should take and suggest lines of attack, they will 

 have served their purpose. 



Notable and well established, apparently, 

 is the relationship existing between the 

 gonads, the thyroid and thymus glands, the 

 hypophysis and suprarenal glands. Very 

 difficult is it also to unravel the relationship 

 of the internal secretions as a whole to the 

 nervous system, both central and peripheral. 



In view of the fact that we so little 

 understand the chemical principles elabo- 

 rated in these organs and discharged by 

 them into the blood, whereby the remark- 

 able changes described above are effected, 

 it is evident that further progress now 

 waits on chemical discoveries. 



28 " On Abnormalities of the Endocrine Func- 

 tions of the Gonads of the Male," Am. Jour. Med. 

 Sciences, Vol. 149, p. 1, 1915. 



29 " Eegulators of Metabolism," p. 183. Mac- 

 millan & Co., London, 1913. 



