APPLICATIONS AND POSSIBILITIES
The knowledge that the shape and action of a man's body as well as
his mind depend on the internal secretions inspires the hope of the
emergence of a hitherto inconceivable controlling power over human
life in the future. For in the wake of chemical discovery there has
always come chemical control. The nature of chemical research, the
necessity for clear thinking, accurate measurement, and experience
in the actual handling of materials, the fundamental tradition and
technique of the science, have made and will make the practical
applications about which we today may only speculate. What the study
of the internal secretions suffers from, at the beginning of the third
decade of the twentieth century, is insufficient appreciation of its
meaning for mankind. It is true that there are thousands of workers
scattered throughout the world contributing their mites to the general
store. They increase yearly, almost daily, and their achievements,
in spite of an uncritical enthusiasm in some quarters and a
semi-charlatanism in others, have been and continue magnificent. But
they are pecking at a mountain which requires organized, massive,
engineering organization for its blasting.
The crying need is for an international institute, endowed and
equipped for investigation upon the proper scale, with all the
available appliances and methods already worked out and at hand. Such
an institution would possess the right chemical laboratories for
the making of blood analyses, metabolism examinations, and tests of
endocrine functions. There would be X-ray machines and experts to
radiograph the pituitary, pineal and thymus glands when possible.
There would be psychologists to carry out intelligence tests,
determine emotional reactions, and group mental aberrations,
deficiencies and defectives. There would be statisticians, trained in
biometrics, to criticize and compare data obtained. There would be
anthropoligists to note and measure variations in angles and curves,
ratios and quotients of the external conformation of the body.
Internists would record the history and status of the organs and
viscera. There would be librarians to collect, abstract and collate
the vast, accumulating literature. In short, the mystery of
personality, the most marvelous, complex, and variable process in the
universe, would be attacked and at length penetrated systematically
and persistently, with the ideal of absolute control of its
composition as the goal in view.
The nature of the researches? They would be infinite in their variety
and significance. Their practical by-products, dropped in the pursuit
of knowledge by the scientist, as Atalanta's lover the golden apples
in his race, to assuage the scent of the hard-headed business man,
would be profitable enough for any country in peace or war, to pay
for itself ten times over and at compound interest. A volume could be
filled with suggestions for interesting and promising investigations.
But we may glance at some of the immediately useful aspects that might
exercise those concerned with the everyday life of men, women and
children.
THE ENDOCRINE EPOCHS OF LIFE
There is no more famous classifications of the epochs of life
that mark off the milestones of the individual's evolution than
Shakespeare's Seven Ages. So different is he at those different stages
of his development, so changed his body and mind that it has become a
part of popular physiology that we are entirely made over every seven
years, and that no cell in the organism lasts longer than that. The
tradition certainly does not apply to the brain and nervous system,
for the number of brain cells is fixed at birth, and cannot be
increased, only decreased, because they are too highly specialized to
reproduce themselves.
What transfigures the individual as the years go by is no simple wear
and tear of the tissues, nor the replacement of old cells by new. It
is the rearrangement of relationships among the ductless glands, the
shifting of influences from the predominant to the subordinate, and
vice versa, in the constellation of the internal secretions, that
determines the unfolding of the personality. The transformations raise
doubt sometimes as to the reality of personal identity. What actually
happens in the changes from childhood to adolescence, from adolescence
to maturity, and so on, is the sloughing of one internal glandular
dominance for another.
Growth, as a general name for the mutations, the ensemble of somatic
and psychic differentiation, from year to year, passes through five
epochs that are standard for the normal. The normal is the being who
harmonizes with his environment, and yet reacts with it because of
recurring needs within him. His endocrine equation settles what is
unique and different in him. But the gland which flourishes during the
epoch as its time of triumph, when it has its day, determines what
makes him like his fellows.
From this point of view it becomes permissible to speak of the five
Endocrine Epochs. Similarities and resemblances of mind and body
between people at a given period of life, childhood, youth, maturity
must be put down to their common government by the salient endocrine
of the epoch. So one may list:
Infancy as the epoch of the thymus
Childhood as the epoch of the pineal
Adolescence as the epoch of the gonads
Maturity as the epoch of whatever gland is left in control as the
result of the life struggle.
Senility as the epoch of general endocrine deficiency.
Infancy as the epoch of the thymus explains why, in any given
geographic locality, the babies look alike and act alike. Specialists
in the observation and treatment of infants have noted that not until
after the second year is any tendency to differentiation discernible
to any extent among them. It is only after the second year, or
somewhere around that time, that the child begins to individuate, and
distinct individual traits and a personality manifest their outlines.
The thymus is the great inhibitor of all the glands of internal
secretion. By its checking activity upon the other members of the
endocrine system, the thyroid and pituitary in particular, it gives
the baby time to grow in bulk, which is its chief business during the
first two years of its existence. It quadruples its birth weight. The
brain and nervous system complete their growth in mass by the end of
the fourth year. Recall the experiments of Gudernatsch working with
tadpoles, who showed that feeding with thymus produced giant tadpoles
whose metamorphosis into frogs was inhibited, while feeding thyroid
produced frogs the size of flies. Differentiation occurred without the
preliminary increase in mass usual. As differentiation and bulk thus
appear antagonistic, at least at the beginning of growth, the function
of the thymus, at a maximum during infancy, seems then to be to
restrain the differentiating endocrines, until sufficient material
has been accumulated by the organism upon which the differentiating
process may work.
After the second year, the thymus begins to shrink. That is to say,
officially its involution begins. Careful dissection will demonstrate
some thymus tissue even in a normal subject up to the fourteenth year.
This refers to the average normal, for the large thymus may continue
large and grow larger after the second year in the type of individual
designated in a preceding chapter as the thymocentric.
If the thymus retrogresses after the second year, what takes its place
as a brake upon the forward driving impulses of the other endocrines?
We have every reason for assigning that rôle to the pineal. It
performs its service mainly, in all probability, by inhibiting the
sex stimulating effect of light playing upon the skin. Since it is
especially a sex gland inhibitor, the thyroid and pituitary become
freer to exert their influences than under the thymus régime. And so
we find that it is after the second year that thyroid and pituitary
tendencies manifest their effects. The Pineal Era, from the second
to the tenth to fourteenth years, remains to be investigated from a
number of viewpoints interesting to the parent, the educator, and
the student of puericulture. Precocity is directly related to early
involution of the pineal. For just as the thymus involutes at the
second year, the pineal atrophies before the onset of adolescence.
Adolescence is the period of stress and strain throughout the somatic
and psychic organism because of the volcanic upheavals in the sex
glands. The history of the individual is dominated by them up to
twenty-five or so, when maturity commences in the sense of a relative
sex stability. They continue to exert a powerful pressure throughout
maturity. But life episodes and crises, diseases, accidents, and
struggles, experiences of pleasure and pain, as well as climatic
factors, settle finally which endocrine or endocrines are left in
control as a consequence of the series of reactions the period of
maturity may be analyzed into.
THE INTERPRETATION OF SENILITY
Senility inevitably follows maturity, not as night follows day by a
mathematical necessity, but because of the process of degeneration
which ultimately overtakes all the glands of internal secretion,
dominant as well as subordinate. Just why the degeneration must occur
no one can say. Injury to the endocrine organs of one sort or another,
ranging all the way from emotional exhaustion to bacterial infection,
is the reason usually considered sufficient. Just why recuperation and
regeneration do not preserve them in the elderly as they do in youth
is a problem to be solved when we understand the laws of regeneration,
at present almost totally beyond our control. Some say that it is a
matter of the wear and tear of our blood vessels, those rubber-like
tubes which transport food and drainage with nonchalant equanimity to
all cells as long as they last. In the classic phrase: a man is as
old as his arteries, ergo his ductless glands will be as old as their
arteries. And the age of arteries is simply a matter of wear and tear,
the resultant of the function which is universal among molecules.
Arteriosclerosis, the hardening of arteries, might be the whole story.
But there are certain experiments and considerations which rather
confute that easy explanation, or at least make clear that the mystery
is not so simple. The work of Steinach, a Viennese investigator, has
contributed most to the elucidation of the nonarterial factor in
senility. No one has asserted more loudly the importance of the
interstitial cells that fill in the spaces between the tubules of the
testes in the male, and the follicles of the ovary in females. Rats
have been his medium of study, for they are most easily procurable,
live fastest, breed, and withstand experimental and operative
procedures better than any other animal.
An old rat is like an old man in his dotage. His bald, shrivelled skin
covers an emaciated body. His eyes are dimmed by cataracts and his
breathing is labored and difficult because his heart muscle has lost
its tone. Huddled in a corner, life to him has become concentrated
into the desire for a little food, and immobility. If now, something
is done to his sex apparatus, a marvelous transformation may be
effected. That something no one could predict. It consists in slitting
the genital duct, which leads from the germinal cells to the exterior.
After the operation, the germinal cells, which grow into the
spermatozoa, atrophy and disappear, since they can no longer function.
As if released from some restraint, the interstitial cells, however,
multiply enormously. With their multiplication, the miracle of
rejuvenation is performed.
After some weeks the sluggish currents of being in the rat, which had
slowed down as a preliminary to stopping altogether, flow fast and
furious. Waves of new chemical substances inundate his cells. And they
respond like the fields that border the Nile after the annual flood.
All his tissues, skin, muscle, nerve, even bone, are restored. A
vitality is created which makes him bound and dart like a youth of his
species. In due time, though, senility returns. It is as if a storage
battery, recharged, runs down and becomes dead again. Slitting the
genital duct of the other testis, causing its interstitial cells to
hypertrophy and multiply, repeats the effects of the first experiment.
The organism responds again to the new waves of vitality that vibrate
through it. That it is recharged is demonstrated again by a revival of
sex appetite and sex activity. The female which had become an object
of indifference is reinstated as a creature to be sought and pursued.
The second period ends in its turn. And now entirely new interstitial
glands, in the form of fresh testes removed from a young animal, are
transplanted into the body of the old rat. Once more youth returns.
But now it burns itself more quickly than even before. An acute
exhaustion of the mind appears first. Then all the other phenomena of
old age steal back upon the old rat, and senility, firmly established
in the saddle, rides him to the end.
THE POSSIBILITIES OF REJUVENATION
Whatever other deductions may be extracted from these experiments,
they prove beyond a doubt the existence of an endocrine factor in the
process of aging, as well as an arterial. They also demonstrate that
the internal secretion of the sex glands, well advertised as it has
been as the Elixir of Youth that Ponce de Leon, and Brown-Séquard with
so many others, pursued in vain, is not the whole story. For if it
was, the duration of the new youth should be another span of life,
whereas in actuality it is only a fraction of that time. This fact,
together with a number of others, make clear that while the gonads may
be the jeune premier of the drama, the vitality of the plot depends
upon the other endocrines. Since old age is an exhaustion, permanent
and irreparable of _all_ the members of the ductless gland
directorate, the reason becomes clear for the temporary quality of the
rejuvenation effected by the procedures of Steinach.
Practically, then, the question at once arises: which of the glands in
particular are involved? There is first that ubiquitous agent in the
system, the thyroid. Chemical analysis of it has shown that the
iodine content decreases with the age of the individual, and becomes
specially low after forty. It is after the menopause in women that
myxedema, the disease of complete degeneration of the thyroid, and of
the physical and mental faculties, is most frequent. The thyroid
of old people exhibits, in varying degrees, signs of a similar
degeneration. Thyroid feeding, properly controlled, will clear up
certain of the deteriorations of mind and body observable in the aged.
The grossness of the features lessens, a number of the pains go,
muscular endurance increases, memory and intelligence do not remind
one so forcibly of the old dotard in his second childhood. Of course
the improvement at present achievable is only relative. But in the
prematurely aging, decay invading a half accomplished maturity,
marvels have been achieved at times with feeding of the gland.
The pituitary, too, begins to retrogress after the period of maturity.
And an early retrogression means a short maturity. In women, the onset
of an obesity, and coincidently, of a lazy and dull morale, coincides
with this declension of the pituitary powers. All the glands of
internal secretion, in fact, shrink and shrivel as old age advances.
Only, as in other relationships, the predominating endocrine stamps
its signature more visibly upon the documents of decadence than the
others. Pituitary types, as said, get fat and slow, thyroidal become
bulky and stupid or thin and sour, the adrenal dark, shrunken and
forever tired of life. So type emerges, even in all-around glandular
deficiency.
The problem of rejuvenation is the problem of recharging, or replacing
all of the glands of internal secretion, at least the most important,
the thyroid, the pituitary and the adrenals, as well as the gonads.
Longevity is perhaps largely a matter of preventing, or postponing
their wane. Beside, there is the prophylaxis of bacterial infections,
and their all embracing corrosions--which, too, have an endocrine
aspect.
Persistence of youth or juvenility may be manufactured by nature in
two ways. There may be a persistence of early glandular predominances.
We have seen what happens to the thymocentric. That a pineal-centered
juvenile or infantile type exists may be safely predicted. Nature's
only other mode of securing perpetual youth seems to be by prolonging
the time allotted to the sex gland crescendo.
As for the golden age of maturity itself, what humdrum people and
poets have despised as middle age, the margin of reserve of the ruling
hormone is a quantity almost malleable in our hands, but still to be
regarded with respect as a hard cold proposition by the physiologist.
In general, the continuance of any stage of development means the
maintaining of the glandular administration peculiar to it. So the
chubby debonair irresponsible whom nothing can touch is happy in the
possession of a pineal uncorrupted by the years, while the genius who
can turn out his best work at sixty-five must thank his pituitary for
standing by him to the end.
THE SCIENCE OF PUERICULTURE
There is a specialty now growing in the womb of science which in its
own good time will come to fruition as the study of the child's needs
or puericulture. Even today there exists a scientific basis for the
formulation of the principles upon which every child should be brought
up. Though we have had marvelous results from the campaigns to lower
infantile mortality, most of what has been done has been medical in
its interest, and so largely negative in its accomplishments. The
removal of the causes of evil no doubt gives the good its opportunity.
But how to raise a child, endowed with satisfactory ancestral stuff,
as a Grade A normal or supernormal, still remains to be erected into
an exact science.
A number of attempts have been abortive in this field. Why they have
failed to arouse the ardor of the parent has puzzled some of the
pioneers. Child-culture as the foundation of all systems of education
has continued more or less of a hope rather than an achievement
because of a lack of appreciation of the different constitutional
varieties of children. A certain amount of attention has been lavished
upon children needing special attention, those mainly suffering from
insufficient development of one sort or another. In the last decade or
so, an endeavour to focus upon the exceptional child, exceptional
in intelligence or some special creative endowment, has started an
interesting movement. All of them have suffered from the fallacies and
troubles of the pure psychologist who would handle mind as an entity
in a vacuum.
A realization of the different physical and psychic educational
needs of various children will arrive only when we see them as built
differently. Just as shoddy and silk, cotton and wool, alone or in
combination, all possess different qualities as wearing material, so
different children have varying capacities for the wear and tear of
education. The endocrine classification of the human race, applied
to children, will here yield a harvest to the educator and to the
country. Nothing is more evident than the diversified nature of the
needs of the various internal secretion types, once they are realized
as such.
The history of a thymocentric type, for instance, is predictable from
the very first few months of his life. Difficulties in feeding, in
habit formation and adaptation, in the reaction to infections, in
social play and so on, one may expect for him. The course of events
for the other endocrine types also follow laws of their own. It will
be above all in the _understanding_ of children, their make-up,
reactions and powers, that the biologist will achieve some of his
finest triumphs.
The educator will have to take account of the state of the pituitary
in estimating the normal intelligence, or influencing the abnormal or
subnormal intelligence. As well will he have to consider the thyroid
in the child whose conduct is refractory, even though his proficiency
in his studies is excellent. And the condition of the adrenal will be
ascertained in the types that tire easily, and that seem unable to
make the effort necessary or desirable. Periodic seasonal and critical
fluctuations in the equilibrium among the hormones will have to be
taken into account in the explanation of what have hitherto been put
down to laziness, naughtiness, stupidity, or obstinacy.
A child's capacity for education, essentially its capacity for the
highest and most productive kind of life, is limited by inherent
factors. These factors are two: the quality of the nerve tissue, its
ability to make a number of associations, and the quantity of the
internal secretions, measured by the maximum obtainable in a given
situation. These inherent factors explain, too, why children born
and bred in virtually the same environment show the most extreme
differences in educability. That the differences are inherited was
made evident by Galton's finding that the chance of the son of an
eminent man exhibiting eminent ability was 500 times as great as that
of the son of a man taken at random.
Every baby, then, is born with a combination of nerve cells and
ductless glands which determine its capacity for mental development,
that might never be realized, but could never be exceeded. If, in any
family, minor differences in educability are observed, they can be
put down to disturbance of these two factors occurring after the
fertilized germ cell had started to divide and reproduce itself. But
any marked falling off in either the nervous or endocrine factors has
to be considered pathologic, due to an impairment of them by adverse
environment.
Recent studies have amply established that the proportion of
certifiable mental defectives, and of a much larger class, the
subnormal but not certifiable class, is progressing by leaps and
bounds. It is perhaps the most absurd frailty of our present system
of education that it takes almost no account of innate differences in
educability. To spend money upon the teaching of these children along
lines where they are unteachable is not only waste pure and simple,
but crime, for it deprives the educables of their just due.
These, of course, are the crude and simple lines upon which the finer
and more complex evolution of the endocrine problems of the school
child will build. The fine art of education itself is crude and gross
and simple compared with what it might be, even as a beginning. The
science of education has yet to begin, as the offspring of that
science of the future, to which knowledge of the internal secretions
will contribute no little, the science of puericulture.
VOCATIONAL EDUCATION
It is difficult, indeed, to avoid becoming merely enthusiastic upon
the possibilities of the applications of the endocrines to the
educational domain. Happiness for the average individual consists of
a double success--success in his vocation (chosen or forced upon him)
and success in his sex life. A certain hue and cry has been raised in
the last few years concerning the vast and overwhelming importance of
sex in the happiness and even in the successes of a man's everyday
life. And no doubt there is a relation. Sublimation plays its part in
the explanation of vocational idiosyncrasies. The fact, however, that
perfect success in sex may occur with absolute failure in the career,
however, splits the problem for good into its realities: a physiologic
aspect as well as a psychologic.
So, as school education will have to take serious account of endocrine
anomalies and possibilities, will the institution which selects and
trains for a career. Vocational misfits have aroused the ardor of our
efficiency experts. And again, the sweeping psychological attack has
beaten its head against the stonewall of ignorance of constitutional
predispositions and tendencies of material. The attempt to erect
psychologic types for vocational selections could never make much
headway because it could only flounder in a swamp of metaphors,
product of the vices of its methods. Not that anyone would wish to
discard at all the psychologic mode of approach. But no science, in
the sense of accurate examination, was possible, in the matter of
classification for vocation, without the insight into the physiology
of the candidate that the analysis of his endocrine formula will
provide.
One need not dilate upon the value of such an examination.
Civilization has not yet learned how to pick its personnel. And so
artists and scientists, philosophers and politicians, financiers and
religious leaders, arise and survive by the operation of the laws of
probabilities and chances, rather than by any intelligent selection
and cultivation of material. The case, indeed, is simply a subdivision
of the vast subject: haphazard muddle in the conduct of life. A cry
has been raised for the superman, and a cry has been raised for a
method of anthropometry. For the lack of these two, it has been
said, all governments have been doomed to defeat. The study of the
endocrines will by no means supply a panacea. But as it will furnish a
means of approach to the determination of how men and women are built,
and why they are built differently, no one can gainsay the tremendous
advantages to the nation that will proceed to classify its population
accordingly, and know its strength and weakness in terms of the actual
generators of success and failure.
Suggestions have been offered in the preceding pages of concrete
applications of endocrine knowledge to the understanding of behaviour,
of the genius and commonplace, criminal and Puritan. And in the
chapter on historic personages, we tracked some of the story in
detail. This vein when explored will quarry untold riches. It has been
observed that financiers of mark, like great musicians, are special
pituitary types. Also that the financiers are voracious meat eaters
and the musicians inordinately fond of sweets. Differences in anterior
and posterior predominances might account for this. That we are
playing here with no phantasy is proven by the fact that we can effect
changes of tastes as well as of intellectual direction by appropriate
feeding of various glandular extracts. Just as much, indeed, as we can
influence sex susceptibility, and the reaction to sex stimulation, by
the artificial introduction from without of the proper hormones.
FATIGUE AND INDUSTRY
In industry, business and profession, the biologist will come more and
more to be called as consultant. Labor unions as well as the large
employers of labor, and their employment managers have given much
thought to the problem of fatigue. Just what fatigue is, why different
individuals tire at different rates, why some are constructed for
monotonous routine while others must have constant variety and change,
the relation to accidents and to quantity output, are a few of the
major lines of inquiry upon which the endocrines obviously have a
large bearing. To the employment manager, labor turnover and the
selection of personnel are adjacent fields of research.
Fatigue as an endocrine deficiency--a depressed state of one or
more of the glands of internal secretion, abolished when its normal
functioning is restored--is a general principle from which departures
of exploration of sub-problems will proceed. An endocrine organ will
secrete at a certain rate. When it is stimulated excessively, it will
eject extra amounts of its secretion. How long the period of excessive
stimulation may last must depend upon the secretion potential or
margin of reserve of the cells, varying from organ to organ, and from
individual to individual. After that, exhaustion and failure follows,
with the onset of the symptoms of fatigue.
A pretty demonstration of this process has been worked out in the
electrical stimulation of muscle. If a muscle, say the biceps, is
irritated by an electric current, it will contract. As the strength of
the current is increased, the degree of contraction becomes greater.
A sort of stepladder effect of increasing contractions may be thus
obtained. After a time, the electric shocks cannot cause a greater
contraction, but only a lesser. And if continued, the muscle will
cease to function because of fatigue. If now, when the muscle begins
to lag in its response, and its contractions to decrease, one injects
into a vein extracts of thyroid, parathyroid, or adrenal glands, they
will immediately reinvigorate the failing contractions. The injections
must be made before the fatigue is carried to the point of absolute
exhaustion. It follows that these glands normally pour into the
circulation substances which counteract the effect of fatigue
substances, and in fact make possible muscular recuperation from
fatigue throughout the day as well as in emergencies and crises.
Fatigue, conventionally recognized, is something acute and urgent. As
such it means a violent draining of the endocrine wells. But there
is also a chronic fatigue, which has been dignified with the name of
Fatigue Disease. Bernard Shaw once asked for someone to tell him
the name of the germ causing the symptoms of overwork. That being
impossible, he will have to be satisfied with the answer that it is
not a germ, but an internal secretion, or rather a defect of internal
secretion that is the cause.
Whether or not the adrenals have been damaged by past experiences,
and upon their capacity to respond to the necessities of an occasion,
fatigue reactions primarily depend. A quotation from Sir James
MacKenzie, most distinguished of modern English students of medicine,
summarizes the matter neatly. "Abelous, and Langlois and Albanese have
studied the relation of the adrenal bodies to fatigue.... They infer
that the muscular weakness following removal of the adrenals is due
to toxic substances. In view of our present knowledge of the
physiological action of adrenaline in its various forms, it seems more
probable that the weakness is to be explained by the absence of the
normal tone producing internal secretions of the bodies in question."
In other words, the adrenals regulate muscle tone. They produce
nature's tonics for weary tissues. The chronic lassitude of thousands
of our generation, suffering from "that tired feeling," may be put
down to chronic adrenal insufficiency.
It requires no superlative imagination to see that an adrenal poor
subject does not belong upon a job that involves muscle stress over a
long period, or indeed fatiguing conditions of any sort. Nor that a
thyroid poor individual is not the best choice for a position that
demands a keen, alert body and mind. In the selection of executives,
the nature and stamina of the pituitary will undoubtedly be taken very
seriously in the near future.
A certain hocus-pocus concerning character reading, a perverted
revival of the ancient phrenology and physiognomy, has invaded the
employment territory in America as the newest charlatanism. The study
of the internal secretions, including blood and X-ray examinations,
will surely assist the demand for a truly scientific estimate
of constitution and character that can be relied upon in the
classification and distribution of personnel.
THE PROSPECTS FOR PUBLIC HEALTH
By their effects upon the endocrines, public health influences like
food, clothing, sleep and overpressure and last but not least,
_disease_, the so-called diseases of childhood, possess a tremendous
importance in limiting the output of the educable. They act to
subtract from and so to lower the rating, the capacity of the
germ-plasm. Most material and vital of these influences are the common
diseases of children, for they strike directly at the glands of
internal secretion.
Measles, scarlet fever, diphtheria, mumps, and the others have long
been accepted as providential visitations for sins known or unknown.
That children had to have them and were better off when they had them
has become part of the tradition of the laity, fostered by the lazy
ignorance of previous medical generations. But today we are beginning
to ask ourselves why children must have these endemic infections
of their age. The pathologist goes farther and asks the reason for
certain apparent immunities. He asks why the little boy who sleeps
with his brother sick with scarlet fever does not contract the
disease, even though not protected by a previous attack.
Determining why susceptibility to a special disease in a particular
case exists will constitute the greatest line of advance for the
understanding and prevention of disease, and so the perfection of
public health. In the last influenza epidemic countless physicians
were puzzled by the spectacle of men and women in the pink of
condition carried off in twenty-four hours while puny associates were
either passed over, or pooh-poohed their colds. Pathologists have
spent their energies fruitfully upon the infectious causes of disease,
the microbes and parasites especially. But now, having solved most of
those problems, the vital question of why an organism permits itself
to be attacked is pushing itself to the front. Why a peculiar ailment
selects its victim, why the bacillus finds a fertile soil, is the
neglected problem, which must be solved before the abolition of
disease and its carriers will be remotely conceivable.
Long ago, Hippocrates, revered founder of the art of medicine,
recognized that there was a specific affinity of disease for
individuals with more or less the same characteristic somatic and
psychic traits and trends. Tuberculosis, for instance, was noted for
its frequency in long-skeletoned, thin persons, remarkably optimistic.
And the plethoric, choleric nature of the sufferer from gout has
become proverbial. Before the era of the great bacteriologic
discoveries of the eighties and nineties, the concordance of esoteric
racial and personal markings was a great help in diagnosis to the
physician. For he realized, though he sometimes credited it to his
clinical intuition, that it was a certain type of personality that was
liable to the specific disease.
But personality and its reactions, normal and abnormal, are determined
by the endocrines. So we should find that particular infections
run with special internal glandular predominances. For the picture
presented by an infection, temperature, rash, prostration, are the
details of the general reaction of the organism in the face of a
new situation, the presence of a powerful, destructive invader.
Information has accumulated that the invader is powerful and
destructive, as well as selective, because of endocrine deficiency of
one sort or another in the body it has attacked. Work of a number of
investigators has indicated that an individual's susceptibility or its
reverse, resistance, is intimately subjected to the derangements or
harmonies of the endocrine system.
Comparison of the endocrine type and the disease assaulting has
yielded an even more interesting principle. Knowing the state of the
internal secretion reservoirs enables us to predict the liability to
certain of these infections of childhood. Diphtheria has been found to
occur most virulently among adrenal poor individuals. Moreover, they
are left poorer in adrenal afterwards. It follows that they would be
assisted by the feeding of adrenal. Mumps is a sickness that sometimes
permanently injures the gonads: the testes or ovaries. The thyroid
dominant, whose system is rich in thyroid, will rarely suffer from any
of the common diseases of children--if at all, from measles. Op the
other hand, those who have every infection of the period, and who, as
their mothers say, seem to get everything, are those whose system
is thyroid poor. Thyroid poverty is a splendid enticement to the
universal microbe. The thymocentric stands all diseases poorly. The
pituitary type is more liable to epidemic meningitis and infantile
paralysis, typhoid and scarlet fever.
The public health officer of the future will be armed with a new
weapon in his fight against the spread of an epidemic. He will be able
to classify the endocrine traits of the population exposed, and to
advise a course of glandular feeding for the types specially liable.
The Schick test for diphtheria susceptibility is an illustration
of one method of approach to the problem of the epidemiologist in
settling who needs protection. The endocrines will assist him in the
great body of diseases for which no immunity test is at hand. Should
another influenza epidemic come along, for instance, the proper
handling, from the endocrine standpoint, of the thymocentrics and
the related adrenocentrics would help considerably in lowering the
mortality.
Endocrine types have other tendencies, which when studied and
controlled, will decimate the great assassins of middle age: heart
disease and kidney disease, with accompanying degenerations of the
blood vessels and circulation. The adrenocentric tends to get up a
hyperacidity of the stomach and a high blood pressure, besides certain
forms of diseases of the lungs. The thyrocentric is predisposed to
heart disease, as well as intestinal disturbances. The pituitocentric
is liable to periodic and cyclic upsets in his health.
Narcotism, the craving for narcotic or stimulant drugs, and its
subvariety, alcoholism, has been found most often among the
thymocentrics. Any type of endocrine inferiority, interfering with
success in life, may lead to the habit of drug addiction as one way
out. But the blood and tissues of the thymocentric appear to become
habituated to the narcotic stimulant more easily than the other types,
and so to demand it with a physical imperative comparable to the food
or sex urge. Among artists, philosophers and statesmen, on the other
hand, actively productive and so contrasted with criminals and
degenerates drug addiction has frequently been a mode of endocrine
compensation. That is, the drug produced temporarily the effects of
the internal secretion lacking or insufficient. Thus the effects of
cocaine may be compared with the effects of thyroid. But while there
is a normal mechanism for thyroid detoxication, the cocaine or heroin
derivatives mark the tissues permanently with their scars and deform
the personality.
THE HYGIENE OF THE INTERNAL SECRETIONS
All these protean expressions of endocrine determination may now begin
to be looked upon with the hopeful and optimistic attitude of him who
understands cause and effect and can control. The advances made in the
last ten years in the practical manipulation of the ductless glands
from without, the introduction of glandular extracts by feeding or
injection, and the modification of their structure and function by
surgery, the X-ray and radium, and other procedures, enable us
to regard more confidently the problems hitherto accepted as the
insoluble and intricate handiwork of Fate. Fate may have woven the
patterns of our being. But as we commence to probe the machinery and
to examine the looms more carefully, we begin to understand why the
wheels creak, and why there are seconds and odd lots in the product as
well as the rare and precious firsts. Moreover, we are learning how to
handle the machinery ourselves. The abdication of Fate can therefore
be confidently expected in due time.
However, we have yet to begin, and we can begin with prevention. The
theory of Adler, that some organ inferiority is responsible for much
unhappiness in life has received much advertisement in conjunction
with the doctrines of the Freudians. It is a theory of little scope
when applied to the eyes, ears, heart and so on because only a small
minority of the cases are of that kind. But as we have seen, a
deficiency of an internal secretion, an endocrine inferiority,
reverberates throughout all the cells. Not only the mind, but all of
the members of the organism must strain and co-operate to make up for
the break in the balance.
Endocrine inferiority is indeed the most frequent organic inferiority.
And we may explain a number of mental types upon that basis. Thus the
inferior gonado-centric, who has something wrong with his reproductive
organs, will evolve in one of two directions. If his adrenal and
thyroid are of poor quality, he will become the secluded introvert,
shut off from the interests of normal life. He will enter the
borderland of insanity if pituitary difficulties supervenes. If, on
the contrary, the adrenal, thyroid and pituitary are present in
a certain proportion, he will become the active, aggressive,
never-resting, keen, and relentless fanatic reformer. A woman who is
gonad deficient with a superior adrenal will suffer from virilism
and specialize in the extreme tactics and mythology of the feminist
movement. A number of life reactions are classifiable as the strivings
of endocrine inferior individuals to overcome their sense of
inferiority. The unconscious vegetative system and the system of
consciousness are both modified by the weakness of a link in the
glandular chain.
What, therefore, is to be recommended in the prophylaxis of the
natural deterioration of the wells of life, the ductless glands? For
even if we may be able to replenish them when they dry up, would it
not be better to delay their dessication? The hormones reply to every
call of life and respond in every reaction. The normal constructive
process of their cells remanufactures what has been lost, and the
original capacity to respond is restored. If, though, the rate of
destruction and loss outruns the rate of repair and construction, they
will be permanently damaged. This is what occurs in shock, serious,
severe accidents and injuries, prolonged infections and diseases,
profound continued emotions, and the wear and tear of overwork. The
prevention of these excessive fatigues of the endocrine system in one
or all of its parts, and especially the prevention and enfeeblement of
the diseases of children which injure them at a period when they are
most sensitive to injury, is the task of the endocrine hygienist.
Periodic examinations, to check up the balance sheets of the hormone
factories and to measure the amount of their damage by means of blood
analyses, will provide the most valuable method in the campaign to
lengthen the productive and enjoying span of life.
THE TREATMENT OF CRIME
Endocrine hygiene will discover no wider or more fruitful area for
exploration and control than that of crime. For more than a generation
there have been attempts at a criminology, and a new understanding and
control of crime. In the United States a concomitant sentimentalism
has concocted measures like the honor system which, naturally failing
of their purpose, have undermined confidence in the idea of scientific
diagnosis and treatment of crime. As someone has noted, to ask a
criminal to promise not to misbehave, when discharged from prison,
is like asking a typhoid fever patient to promise not to have a
temperature above ninety-nine degrees the next morning. For a large
proportion of criminals--the percentage has yet to be determined,
although the most recent police commissioner of Chicago has estimated
it at ninety per cent--punishment for a period of time and then
letting him go free is like imprisoning a diphtheria carrier for a
while and then permitting him to commingle with his fellows and spread
the germ of diphtheria.
Of course, the doctrine of responsibility is all tangled up with our
attitude towards and treatment of crime. Though clear thought makes
mandatory the recognition of a universal cause and effect law,
practical common sense has defined free will. Consent or the
withholding of consent to a given course of action has been the
criterion of responsibility.
In practice, the limitation of responsibility will depend upon the
insertion of extraneous factors into the formula of consent. The
pragmatic test has been and will be the probability that the
correction of the somatic or psychic condition would have prevented or
will prevent the consent to the crime. As long as no such condition
will be demonstrable, society for its own protection will have to
confine the unfortunate individual.
The character of the confinement, its duration, and the uses to which
it will be put should be dominated by the idea of discovering
the unknown criminal predisposition. If crime is an abnormality
scientifically studiable and controllable like measles, court
procedure and prison management will have to be transformed radically.
There is scattered throughout the world now a group of people who are
applying medical methods to the diagnosis and treatment of crime. They
are the pioneers who will be remembered in history as the compeers of
those who transformed the attitudes toward insanity and its therapy.
The insane were once condemned and handled as criminals are in most
civilized countries yet. The criminologic laboratory as an adjunct to
the court of justice, like that associated with the court of
Chief Justice Olson in Chicago, remains to be universalized. What
contribution to a more rational treatment of the criminal will the
study of the internal secretions make?
It has been shown that the greater number of convicts are mentally and
morally subnormal. To explain the subnormality, the criminologist
has conducted and will continue to conduct investigations into the
heredity and early environment of the criminal, his education and
occupation, the social and religious influences to which he was
subjected, and the intelligence test quotient. The conditioning of the
vegetative system and the endocrine status of the prisoner, however,
will without a doubt come to occupy the leading positions in any
interpretation of crime in the future.
Introspective observation of pre-criminal states of mind by so-called
normal persons reveals that in many of them there is an impairment of
reason and will power, in others an exaltation amounting almost
to hysteria. What are these but endocrine states of the cells,
experimentally reproducible by increasing or decreasing the influence
of the thyroid, the adrenals, the pituitary? Crimes of passion may be
traced in no small part to disturbances of the thyroid. A psychologic
examiner of a Pittsburgh court, interested in the subject, has found
an enlarged thyroid in over ninety per cent of delinquent girls.
Similarly, crimes of violence may be ascribed to a profound break
in the adrenal equilibrium. Criminal tendencies in women during
menstruation and pregnancy, periods of deep-seated mutation in the
internal glandular system, have long been noted. A kleptomania,
uncontrollable desire to steal, confined to the duration of pregnancy
alone, has been described. We have seen how the thymocentric,
especially if he possesses a small bony case for his pituitary, is
predisposed to crime. A recent study of twenty murderers in the State
of West Virginia showed them all to have a persistent thymus and the
thymocentric constitution. A study of the recidivists, those who
return for second and third offences, in one institution, disclosed
that a large majority had a subnormal temperature and an increased
heart and breathing rate. These are endocrine-controlled functions.
Conduct, normal or abnormal, being the resultant of the conflict of
conscious and subconscious impulses and inhibitions, the internal
secretions as controllers of the susceptibility of the brain cells to
impulses and inhibitions, must be held accountable for a portion at
least of the chemical reactions behind crime.
It is possible, by X-ray treatment of the thymus, to cause it to
shrink to more normal proportions. It is possible, by feeding various
glandular extracts, to correct deficiencies or excesses of their
function, and so to remedy the underlying basis for a criminal career.
Here and there work of this kind has been successfully carried out in
selected instances. What a suitable drive upon the whole matter would
yield in happiness to the individual and dollars and cents to society,
time alone will show.