HYPERSECRETION

HYPERSECRETION, HYPOSECRETION, increased or decreased production of secretion, a term applicable to characterizing the functional state of glands, both with external and internal secretion. The entire complex interplay of the endocrine apparatus and almost all its pathology comes down to the fact that one organ or another, under the influence of certain causes, exhibits signs of one of the two above-mentioned conditions. It is true that one also speaks of dysfunction, or dyssecretion of endocrine organs, by which is meant a deviation of the organ's secretion from the norm not in quantitative but in qualitative terms, in the sense of producing a qualitatively unusual secretion, but still the first two deviations of gland function have greater significance, at least due to their much greater definiteness. The consequences of hypersecretion and hyposecretion are determined by the degree of deviation, but are often very demonstrative and substantial. Hyposecretion of the thyroid gland, for example, gives the phenomena of myxedema and decreased intelligence, while in growing individuals it also causes retardation in growth; hypersecretion of the same organ gives the picture of Basedow's disease. Hyposecretion of the anterior lobe of the pituitary in childhood leads to pituitary dwarfism; hypersecretion leads to acromegaly (see) and gigantism (see Giants, gigantism). Hyposecretion of the sex glands, or so-called hypogenitalism (see Hypergenitalism, Hypogenitalism), can sometimes give the picture of eunuchoidism; hypersecretion sometimes gives the picture of so-called pubertas praecox. The latter, i.e., early sexual maturity, as well as early general physical development (so-called macrogenitosomia), is also associated with hypersecretion of the adrenal cortex (adrenal hypernephromas) and hypopinealism (hyposecretion of the pineal gland). Hyposecretion of the adrenal glands underlies Addisonism and true Addison's disease; hyposecretion of the parathyroid glands underlies tetany and spasmophilia, and hormonal hyposecretion of the pancreas underlies diabetes. The opposite condition of the parathyroid apparatus is assumed in the pathogenesis of periodic myotonia and severe pseudoparalytic myasthenia, and many are inclined to attribute a significant role to hypersecretion of the chromaffin part of the adrenal glands in the development of essential hypertension, although this is far from proven. As for hormonal hypersecretion of the pancreas, nothing is yet known in this regard; it is not even known whether such a condition occurs, although, by analogy with other endocrine organs, one should assume the possibility of hypersecretion here as well. Hypo- and hypersecretion of external secretion are observed very often in pathological physiology, mainly on the part of various digestive organs (salivary glands, stomach, pancreas, intestine, liver). Hypersecretions here most often have a quantitative character and can hardly be isolated as independent nosological units, as was previously assumed, or even recognized as absolutely pathognomonic for certain diseases. Most often, hypersecretions accompany individual disease forms (e.g., salivation in bulbar paralysis, hyperchylia in stomach and duodenal ulcers) and indicate a violation of the function of the secreting cell. The question of whether purely qualitative enhancement of function (e.g., hyperchlorhydria) can be classified as hypersecretion remains controversial to this day. Finally, the dynamic study (curves) of gastric juice secretion showed that what seems in statics to be normal but prolonged (extended in time) reactions to endogenous or exogenous irritants (for example, in pyloric stenosis) should probably be classified as hypersecretion. Hyposecretion, and as its rarest manifestation, achylia of the stomach and pancreas, are observed no less frequently on the basis of organic changes (atrophic processes) or temporary suppression of the function of the corresponding secretory apparatus, for example: atrophic gastritis in alcoholics, achylia in cancer patients, anemics (anaemia perniciosa), in neuropaths, etc. (For more details, see also Stomach, Pancreas, Intestine, etc.)