Endocrinology

ENDOCRINOLOGY (from Greek endon-within, crino-I separate and logos-teaching), the doctrine of the endocrine glands (see) or in a broader sense the doctrine of humoral auto-regulation of the organism by means of hormones (see). In the development of this doctrine, 3 epochs can be distinguished. The first - from ancient times to the middle of the 19th century, when E. was based on crude empirical observations and speculative natural-philosophical reasoning about the functions of endocrine glands. Even in this epoch, all endocrine glands were described, with the exception of the parathyroid glands, but the functions of these glands were represented in the most indefinite terms. At the end of the 18th century, Borde (who was also the founder of vitalism) discovered a fairly clear understanding of internal secretion and expressed the view that all organs of the body secrete specific substances into the blood necessary for the normal functioning of the organism. The first more detailed information about the structure of endocrine glands was given by Malpighi already in the 17th century, but only in 1830 did Müller manage to clearly distinguish internal secretion from external. The first experiments in the field of E. undoubtedly belong to Berthold (1849), who removed the testicles from young roosters and transplanted them into the abdominal cavity; no phenomena of castration were observed in this case. These remarkable works did not attract due attention from contemporaries and only later did Biddle emphasize their significance. Approximately at the same time, the first description of Basedow's disease (Zarr, Greve, Basedow) was given. The second epoch, which can be designated as experimental-clinical, begins with the works of Claude Bernard (1857), who introduced the term "internal secretion." Claude Bernard showed that in the liver, along with the formation of bile (external secretion), glycogen is formed, and from it glucose, which is associated with the internal secretory function of the liver. As endocrine organs, he considered the thyroid gland, adrenal glands, spleen, and goiter gland. The most important experimental works concerning the influence of removal of the thyroid gland (Schiff) and adrenal glands (Brown-Séquard), and clinical works - the insufficiency of the adrenal glands described by Addison (1851), as well as myxedema (Gull, Ord, Charcot) also belong to this period. In 1882, Kocher and Reverdin showed that myxedema is caused by the loss of function of the thyroid gland. In 1886, Möbius linked Basedow's disease with hyperfunction of the thyroid gland. If Berthold is to a certain extent the founder of experimental E., then Addison must be considered the founder of clinical E. Despite such great achievements, E. did not attract sufficient attention, and only in 1889 did the works of Brown-Séquard on the stimulating effect of injections of testicular glands (results of experiments on himself) arouse general interest. In the concept of Brown-Séquard, the most significant is the idea of humoral correlation of individual organs. In addition, he must undoubtedly be considered the founder of rational organotherapy. From this time on, continuous growth began in the field of both experimental and clinical E. It was finally established that the thyroid and parathyroid glands, pituitary gland, gonads, and adrenal glands have a definite influence on the development and metabolism of the entire organism as well as of individual systems and organs, and a more distinct connection between the endocrine glands was discovered. At the end of the 19th century, a number of hormones were isolated - adrenaline (Aldrich-Takamine) and pituitrin in a relatively pure form, and later thyroxine (Kendall, Harrington). The discovery of pancreatic diabetes (Mering-Minkowski, Saltykov, Sobolev) revealed the importance of the pancreas in the pathogenesis of diabetes. Approximately at this time, descriptions of acromegaly (Marie), adiposogenital dystrophy (Frolich-Babinski), tetany (Chvostek, Frankl-Hochwart) and others date. However, along with great successes, a crisis in E. begins to take shape, which is facilitated, among other things, by the excessive expansion of the concept of internal secretion. Works appear that show that the changes caused by the pituitary gland are also observed with lesions of the central nuclei of the brain, and thus an incorrect assumption arises about the insignificant role of the pituitary gland. At present, there is already sufficient data to speak not about the insignificant role of endocrine glands, but about the significant, and in a number of cases dominant, influence of the central nervous system on the function of endocrine glands in endocrine diseases. The third epoch in E. begins from the moment when biological tests began to be applied, which made it possible to account for the minimal amount of hormones, i.e., to standardize preparations by methods more sensitive than chemical ones. Only after the development of appropriate biological tests does it become possible to discover this or that hormone. In 1921, the growth hormone (Evans) was thus discovered, in 1922 - the pancreatic hormone (Banting and Best), in 1927 - the hormones of the female gonads and the gonadotropic hormone of the pituitary gland (Zondek and Aschheim, Smith). After these discoveries, a large number of works appeared establishing the more or less exact chemical structure of thyroxine, folliculin, lutein, the hormone of the male gonads, pituitrin, hormones of the adrenal glands and numerous stimulator hormones of the anterior pituitary gland (thyrotropic and others). The connection between hormones and vitamins, between the endocrine and central nervous systems has been established. All these works have laid a solid scientific foundation for endocrinology. A number of journals devoted to E. appear. The first of these journals appeared in America under the title "Endocrinology," then in France - "Revue franc. d'Endocrinologie," in Germany - "Endokrinologie," in Italy - "Endocrinologia," in the USSR - "Mediko-biol. zhurnal" and "Vestnik endokrinologii." The production of organ preparations and hormonal preparations sharply increases, new sources of raw materials for hormone production appear, such as the urine of pregnant women, the placenta. E. in the USSR begins to develop as an independent discipline only after the October Revolution. As early as 1919, a special Endocrinological Institute is organized in Kharkov (V. Ya. Danilevsky), and in 1922 in Moscow an Organotherapeutic, later Endocrinological Institute is organized (V. D. Shervinsky, later N. A. Shereshovsky). Starting from 1925, a number of special endocrinological clinics are opened at the Mediko-biol. institute in Moscow (M. Ya. Sereysky), Leningrad (M. Ya. Breitman), in Kharkov (V. M. Kogan-Yasny). At present, there are also 2 special institutes: for metabolism and endocrine disorders (I. N. Kazakov) and the Institute of Urogravido-therapy (A. A. Zamkov). The Kharkov Institute of Endocrinology, the factory of endocrine preparations in Moscow, the factory "Farmakon" in Leningrad, etc., are engaged in broad production tasks. The development of E. in the Union proceeds in both experimental and clinical directions. The school of Kravkov introduced the method of surviving endocrine organs, which has found wide application in production. The method of vasostomy, proposed by London, is of great importance. A large number of works are devoted to the issues of metabolism in connection with the function of endocrine glands, as well as the question of the influence of exogenous factors on endocrine systems (Alpern, Steppun, Stern and others.). In the field of clinic, special attention is paid to the study of early forms, their diagnosis and therapy, the study of endemic endocrinopathies, in particular goiter and Yurev's disease. The issues of goiter are united and planned by a special commission at the Scientific Medical Council of the People's Commissariat of Health (V. S. Levit). Special dispensaries for endocrine patients are organized. In the Soviet Union, a systematic study of the hormonal action of cell decay products - the doctrine of lysates (Tushnov, Kazakov and others) and the study of the urine of pregnant women as a therapeutic factor (Zamkov) - has been organized. A new field of E. has developed significantly among us - so-called zooendocrinology (B. and M. Zavadovsky, Pavlenko and others.). The problem of reproduction, growth, fat deposition, meatiness, milkiness, wooliness of livestock has been posed in its full breadth - questions of great agricultural importance. Finally, it should be noted that during 1934-35 there were 2 conferences on experimental-clinical E. (Kharkov, Moscow) and one on zooendocrinology (Moscow).