The doctrine of the internal secretory activity of glands in relation to the pathological anatomy of sundry morbid conditions : diabetes, Addison's disease, myxoedema, cretinism, Graves' disease and acromegaly / by J. George Adami.

  • Adami, J. George (John George), 1862-1926.
Date:
[1897]
Catalogue details

Licence: Public Domain Mark

Credit: The doctrine of the internal secretory activity of glands in relation to the pathological anatomy of sundry morbid conditions : diabetes, Addison's disease, myxoedema, cretinism, Graves' disease and acromegaly / by J. George Adami. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    be removed with impunity, has a pituitary body relatively five times as large as that of the dog, in which ablation of the thyroid leads rapidly to symptoms of acute athyrea; or more correctly, the relation- ship of thyroid to pituitary is 3 to 1 in the former, 15 to 1 in the latter animal. On the whole, therefore, anatomical data in connection with myxoedema and cachexia thyreopriva support and are capable of explanation by this doctrine that where glands afford an internal secretion, the development or non-development of symptoms of disease depends primarly upon the relative amount of internal secretion pro- duced and of the substance or substances acted upon by the same. CRETINISM. Cretinism presents a far more complicated histologic *1 picture—so complicated that Bircher (20) argues with very considerable force that “ cretinic degeneration, as also dwarfism and chondrodystrophia foetalis hypoplastica have no setiological connection with the functions of the thyroid,’’ Bircher, however, fails to recognize that if we accept the existence of an internal secretion, we must also admit the presence of substances upon which that acts, and he cannot see that widely contrasted anatomical conditions may lead to the same train of symptoms. We must, I think, abide by the experimental and clinical evidence that removal of the thyroid in the young leads to a condition undistinguishable from cretinism. This being so, we find that in some few cases of typical cretinism the thyroid is completely absent, in a large number it is small, in a yet smaller number accord- ing to Yon Eiselberg (21) and Kocher (22) there is a goitrous condi- tion present, while according to Bircher the goitres may be of all possible forms, from simple hyperplasia through soft (parenchymatous) and cystic to fibroid. The only point clearly to be made out from Bircher’s very destructive criticism is that while in several cases the thyroid has been found of normal size, apparently no case exists in which by microscopical observation it has been found of normal struc- ture. Considering the amount of material he brings forward this is rather remarkable. I further gather that his statements as to the frequency of the various forms of goitre are based upon examination of the living and not upon post-mortem or surgical material. This seriously weakens his case. Beyond this I will not venture to travel. Bircher’s statements require to be dealt with by one in authority, and I await with interest Dr. Osier’s presentation of the matter. EXOPHTHALMIC GOITRE. I will now briefly refer to the condition which presents a series of symptoms so remarkably contrasted with myxoedema—which also