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parasite in syphilis。 Just fifty years had passed since Pasteur had sent in his
paper on 〃Lactic Acid Fermentation〃 to the Lille Scientific Societyhalf a
century in which more had been done to determine the true nature of
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disease than in all the time that had passed since Hippocrates。 Celsus
makes the oft…quoted remark that to determine the cause of a disease often
leads to the remedy；＇*＇ and it is the possibility of removing the cause that
gives such importance to the new researches on disease。
＇*＇ 〃Et causae quoque estimatio saepe morbum solvit；〃 Celsus； Lib。 I；
Prefatio。Ed。
INTERNAL SECRETIONS
ONE of the greatest contributions of the nineteenth century to
scientific medicine was the discovery of the internal secretions of organs。
The basic work on the subject was done by Claude Bernard； a pupil of the
great Magendie； whose saying it is well to remember〃When entering a
laboratory one should leave theories in the cloakroom。〃 More than any
other man of his generation； Claude Bernard appreciated the importance of
experiment in practical medicine。 For him the experimental physician was
the physician of the future a view well borne out by the influence his
epoch…making work has had on the treatment of disease。 His studies on the
glycogenic functions of the liver opened the way for the modern fruitful
researches on the internal secretions of the various glands。 About the same
time that Bernard was developing the laboratory side of the problem；
Addison； a physician to Guy's Hospital； in 1855； pointed out the relation
of a remarkable group of symptoms to disease of the suprarenal glands；
small bodies situated above the kidneys； the importance of which had not
been previously recognized。 With the loss of the function of these glands
by disease； the body was deprived of something formed by them which
was essential to its proper working。 Then； in the last third of the century；
came in rapid succession the demonstration of the relations of the pancreas
to diabetes； of the vital importance of the thyroid gland and of the pituitary
body。 Perhaps no more striking illustration of the value of experimental
medicine has ever been given than that afforded by the studies upon those
glands。
The thyroid body； situated in the neck and the enlargement of which is
called goitre； secretes substances which pass into the blood； and which are
necessary for the growth of the body in childhood； for the development of
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the mind and for the nutrition of the tissues of the skin。 If； following an
infectious disease； a child has wasting of this gland； or if； living in a
certain district； it has a large goitre； normal development does not take
place； and the child does not grow in mind or body and becomes what is
called a cretin。 More than thisif in adult life the gland is completely
removed； or if it wastes； a somewhat similar condition is produced； and
the patient in time loses his mental powers and becomes fat and flabby
myxedematous。 It has been shown experimentally in various ways that the
necessary elements of the secretion can be furnished by feeding with the
gland or its extracts； and that the cretinoid or myxedematous conditions
could thus be cured or prevented。
Experimental work has also demonstrated the functions of the
suprarenal glands and explained the symptoms of Addison's disease； and
chemists have even succeeded in making synthetically the active principle
adrenalin。
There is perhaps no more fascinating story in the history of science
than that of the discovery of these so…called ductless glands。 Part of its
special interest is due to the fact that clinicians； surgeons； experimental
physiologists； pathologists and chemists have all combined in splendid
teamwork to win the victory。 No such miracles have ever before been
wrought by physicians as those which we see in connection with the
internal secretion of the thyroid gland。 The myth of bringing the dead back
to life has been associated with the names of many great healers since the
incident of Empedocles and Pantheia； but nowadays the dead in mind and
the deformed in body may be restored by the touch of the magic wand of
science。 The study of the interaction of these internal secretions； their
influence upon development； upon mental process and upon disorders of
metabolism is likely to prove in the future of a benefit scarcely less
remarkable than that which we have traced in the infectious diseases。
CHEMISTRY
IT is not making too strong a statement to say that the chemistry and
chemical physics of the nineteenth century have revolutionized the world。
It is difficult to realize that Liebig's famous Giessen laboratory； the first to
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be opened to students for practical study； was founded in the year 1825。
Boyle； Cavendish； Priestley； Lavoisier； Black； Dalton and others had laid a
broad foundation； and Young； Frauenhofer； Rumford； Davy； Joule；
Faraday； Clerk…Maxwell； Helmholtz and others built upon that and gave us
the new physics and made possible our age of electricity。 New technique
and new methods have given a powerful stimulus to the study of the
chemical changes that take place in the body； which； only a few years ago；
were matters largely of speculation。 〃Now；〃 in the words of Professor Lee；
〃we recognize that； with its living and its non…living substances
inextricably intermingled； the body constitutes an intensive chemical
laboratory in which there is ever occurring a vast congeries of chemical
reactions； both constructive and destructive processes go on； new
protoplasm takes the place of old。 We can analyze the income of the body
and we can analyze its output； and from these data we can learn much
concerning the body's chemistry。 A great improvement in the method of