CHAPTER V

HOW THE GLANDS INFLUENCE THE NORMAL BODY

The origin of the remarkable differences between individuals that distinguish species, varieties and families, has long been one of the chief puzzles of biology. It may indeed be called the leading puzzle, which led Darwin on to the collection of the data that culminated in the "Origin of Species." The why of the Unique is the fundamental problem of those who would understand life.

An explanation is an attempt at a consistent and persistent, sometimes an obstinate clarity of mind. A vast number of observations gathered by laboratory experimentalists as well as by those naturalists of the abnormal, physicians in active practice, prove that the construction of the individual both during development before maturity, and maintenance during maturity, his constitution, in short, is directed by the endocrine glands. It is possible now to present an explanation of the individuality of the individual.

To assert that variation is responsible for the individual, that it is the mechanism which isolates him as a being like none other of his fellows, not even his parents, brothers, and sisters, is merely to beg the question. What is variation? The internal secretion theory of the process offers, for the first time, an explanation that is coherent and comprehensive, based upon concrete and detailed observations. It provides an adequate interpretation of the numberless hereditary gradations and transitions, blendings and mixtures. It suggests a control of heredity in the future.

THE PURE TYPES

In the pure types, only one gland, either by being present in great excess above the average, or by being pretty well below the average, comes to exercise the dominating influence upon the traits of the organism. As the strongest link in the chain, or as the weakest, it rules. The others must accommodate themselves to it. Among them as commanders of growth, development and normal function, it holds the balance of power. In every emergency it stands out by its strength or by its weakness. It thus creates its own type of man or woman, with attributes and characteristics peculiar to itself. These pure types, as we have seen, are mainly the thyroid, the pituitary, and the adrenal-centered.

Each with the signs peculiar to it can be identified among the faces that pass one in the street. And they differ so markedly among themselves that they provide a new and accurate means of classifying varieties among the races of the species: man. The thyroid type differs as much from the adrenal type as does a greyhound from a bull-dog. The greyhound has a certain size, form, character and capacity. The bull-dog has similar qualities which are yet quite different. Each is built for a particular career. Among human beings, the pure thyroid type is easily distinguished from the pure adrenal type, and both of these from the pure pituitary type. Each is stamped with a significant figure, height, skin, hair, temperament, ambition, social reactions and predisposition to certain diseases.

THE MIXED TYPES

Among the mixed types, the lines of distinction are less clear, and so they are more difficult to classify. The mixed types may be said to be hyphenated. In them, two or even three of the internal secretory glands conflict for predominance. The combined action makes for a resultant modification in the primary glandular markings and effects. A hyphenated classification thus becomes inevitable. Especially is this so if the two glands are mutually antagonistic and inhibitory. A compromise effect is then necessitated. Or an individual may be dominated by one gland at one period of his life and by another at a later period. One of the glands, the thyroid, for example, will show, by the traces it has left upon the earliest developing features, that it was in control at the very earliest dates of his history, while other signs will disclose the more recent influence of the adrenal or of the pituitary. The combination becomes classifiable as the thyroid-pituitary type, or as the thyroid-adrenal type.

That the external features as well as the chronic diseases of human beings are controlled by some common factor has long been suspected. Inquiries into morbid phenomena with a hereditary trend yielded information that has paved the way for the internal secretion theory. It has long been known that certain diseases effect only certain individuals of a definite constitution. Apoplexy, diabetes, arteriosclerosis, Bright's disease, are met with almost exclusively in what the older clinicians talked about as the apopleptic type. On the other hand, they said, anemias, tuberculosis, hemophilias, scrofulas occurred more among the lymphatic type. But they had no idea whatever of the true functional basis of the two different types. The truth as we of today view it is that these two types represent different textures of human beings, fabricated of different internal secretions. They are really two different breeds of the species Homo Sapiens. The materials being different, the color and feel of them is different, and the resistance to wear and tear is different.

ENDOCRINE ANALYSIS

The modes of classification glimpsed at are certainly exceedingly broad and sweeping. It is well enough to establish types and classes. But beneath them are sheltered the infinite possibilities of permutations and combinations, which explain the countless variety and complexity of form and function. Every individual born among the vertebrates, for example, must have a certain definite amount and percentage of pituitary gland, anterior and posterior, pineal, thyroid, parathyroid, thymus, adrenal, pancreas, interstitial and so on. Now if, to state it in terms of percentages, for the sake of argument, the pituitary is 25, the pineal 10, the thyroid 36, the parathyroids 15, the thymus 29, the adrenals 60, the pancreas 49, the interstitials 72 (the gland when acting maximally to be graded as 100), we see at once how different such an individual must be from one who has, say, pituitary 84, pineal 39, thyroid 26, parathyroid 42, adrenals 96, pancreas 22 and interstitials 89. One obtains at once from the contrasts of such figures some idea of the possibilities. As each point plus or minus must count to produce some difference in the individual, the results are manifest.

Varying within the numerical limits imposed by genus, species, variety and family (which limits are probably responsible for the persistence of the particular genus, species, variety, or family) the individual becomes an individual because of the relative values of the percentages in his blood and tissues of these different internal secretions. We thus begin to gain an insight into the patterns according to which men, women and animals are woven.

We are, as yet, far from an exact endocrine analysis of the individual. But we know that the endocrines rule over growth and nutrition, a vast dominion which incorporates every organ and every tissue. By enhancing or retarding the nutritional changes, the growth of the organ or tissue is favored or restricted. The size and shape of an individual, as a whole, as well as of the specialized cell masses composing him, as hands and feet, the nose and ears, and so on, are therefore controlled by them. Whether an organism is to be tall or short, lean or corpulent, graceful or awkward, is decided by their interactions. These, like human covenants, vary with the different reactions of the parties to the contract. And so a great deal depends upon whether they work harmoniously or discordantly, and upon which does the most work and which the least.

Undersecretion and Oversecretion

It is when a gland, either in the course of development, or because of the influence of starvation, shock, injury, poisoning or infection, begins to undersecrete or oversecrete that its effects upon growth and nutrition become grossly manifest. A veritable transfiguration of the individual may occur, the black magic of which may perplex him for a lifetime. A man, made eunuchoid by an accident or by mumps, will observe in himself astonishing changes in his constitutional make-up, mentality and sexuality. He would be more astounded to learn that beneath the appearances, the changes, so alarming him, there are profound alterations in the rate at which he is taking in oxygen, burning up sugar, accumulating carbon dioxide and excreting waste byproducts through the kidneys, which are responsible for them.

The differences between the normal and abnormal are only a matter of degree. And so, to be sure, are differences between types. But it is hard to realize that the striking distinctions between the thyroid type and the pituitary, comparable, as said, to the differences between a greyhound and a bull-dog, are dependent solely upon quantitative variations in the general and local speeds of metabolism, among the cells.

DIVISION OF LABOR

Besides the antagonisms and co-operations between them, there are certain lines along which the glands, in their effects, specialize. The thyroid, for instance, is concerned specially with the regulation of the shape, form and finish of an organ. The pituitary shines at the periods of developmental crises, determining them and modifying them. It exerts the greatest influence upon the time of eruption of the teeth, both the temporary and the permanent, the onset of puberty, the recurrence of menstruation in women, and the time of occurrence of labor. The interstitial glands distribute the basis of the powers and limitations of masculinity and femininity. Abnormalities of these glands also affect the individual all along the line, in all of his aspects. So affected he may apparently change into a wholly different being. He may change in size, in the shape of his head, feet and hands, as well as in his habits, aptitudes and dispositions. So he may find it necessary to purchase an entirely different size of hat, more commodious clothes, and newly fitting gloves and shoes.

At the same time, his family, relatives and friends, discover that the erstwhile generous, frank, neat and punctual and liked, has become stingy and suspicious and slovenly and hated. And all because a gland has begun to undersecrete or to oversecrete. The transformation will be slight or marked, depending entirely upon the extent of impairment, positive or negative, of the gland involved.

But it is not only in the shaping of the normal individual's architecture that the internal secretions dominate. Over that subtle something known in all languages as vitality, expressive of the intensity of feeling, thought and reactions in cells, they rule supreme. Gay vivacity and grim determination, the temperament of a Louis XIV, and the soul of a Cromwell, are the crystallizations of these chemical substances acting upon the brain.

INTERNAL SECRETION VARIETIES

There is no better way of illustrating the influence of the internal secretions upon the normal than the analysis of the variation of traits with variations in glandular predominances. The general build of an individual, his skeletal type, the proportion between the size of his arms and that of his legs, as well as that between his trunk and his lower extremities, whether he is to be tall, lanky and loutish, or short, squat and dumpy, are to be considered. Different facial types are the expressions of underlying endocrine differences. The head and skull offer a number of clues to the controlling secretions in the blood and tissues. Whether the forehead is to be broad or narrow, the distance between the eyes, the character of the eyebrows, the shape and size and appearance of the eyes themselves, the mould of the nose and jaws and the peculiarities of the teeth, are all so determined. The skin, in its color, texture, the quantity and distribution of its fatty and other constituents, eruptions and weather reactions, is influenced.

Also the mucous membranes, the color and lustre and structure of the hair, as well as its general distribution and development, are hieroglyphics of the endocrine processes below the surface. Whether the muscles are massive or sparse, atrophied or hypertrophied, soft or hard, easily fatigable or not, bespeak conditions in the glandular chain. In short, we must regard the individual as an immensely complicated pattern of designs traced by the hormones as the primary etchers of his development. Though it must be admitted that the number of unknown and unsolved relations in the pattern are still enormously great, enough has been established to make possible a rough working analysis of the particular, unique organism placed before us for examination as Mr. Smith, Mrs. Jones, or Miss Smith-Jones.

WHAT IS THE NORMAL?

Anthropologists, from the beginning of anthropology, have battled in vain for a satisfactory inclusive definition, or, at least, description of the normal. With the introduction of the biometric method, the goal at last appeared within sight. A cocked hat curve expressing the distribution and range of the normal looks formidable. The attainable turned out a mirage, for the curves constructable by the measurement of traits of a population only proved the truth of the old axiom that all transitions and variations between extremes exist. The Problem of the Normal seemed more elusive than ever. And the best that could be done for the elucidation of its mystery, was to apply and observe the law of averages.

From the endocrine standpoint, the reason for this becomes clear. The biometric method concerned itself with externals, with, as it were, symptoms. Since these external signs are but manifestations of the inner chemical reactions, of which the internal secretions are the determining reagents, or factors, with permutations and combinations possible in all directions, the diversity and variability of each individual and his traits stands explained and understandable. The normal, as the perfect or nearly perfect balance of forces in the organism, at any given moment, emerges as a more definite and real concept than that which would abstract it from a curve of variations. Moreover, since the directive forces within the organism are pre-eminently the internal secretions, the normal becomes definable as their harmonious balancing or equilibrium, a state which tends not to undo (as the abnormal does) but to prolong itself.

The potential combinations and compensations, antagonisms and counteractions, attainable within the endocrine glands as an interlocking directorate, point the cause for the elusive quality of the normal. Tall men and short men, blonde women and dumpy women, lanky hatchet-faced people, stout moon-faced people, Falstaff and Queen Elizabeth, George Washington and Abraham Lincoln, Disraeli and Walt Whitman, Caesar and Alexander, as well as Mr. Smith and Miss Jones come within the range of the normal. There are all kinds and conditions and sorts of men and women, and all kinds and sorts and conditions of the normal, because an incalculable number of harmonious relations and interactions between the endocrines are possible, and do actually occur. The standard of the normal must obviously not be a single standard, but a series of standards, depending upon which glands predominate, and how the others adapt themselves to its predominance. Adrenal-centered types, thyroid-centered types, pituitary-centered types, thymus-centered types, as well as hyphenated compounds of these, such as the pituitary-adrenal types, exist as normals.

They can be conceived of as normal types because they exist as normal types.

THE SKELETAL TYPES

Now men, for as long as we have any knowledge of their thoughts and classifications and attitudes, have been accustomed to first think of one another, to classify and size one another as tall or short, slender or broad, thin or corpulent. The biological necessity, indeed, instinct of the one animal to relate the other animal to aggressive or harmless agencies in his surroundings, accounts for this. Relatively, of course, for all these modes of description imply offensive or defensive possibilities of the stimulus for the recorder in relation to himself. The interest in stature is fundamental, and has persisted in the most civilized, nations. The relationship of height and weight, as well as of length and breadth, to other physical traits, have formed the subject of scientific study.

There is, for instance, the classification of Bean, who divided mankind generally into two types, those of a medium size, stocky long legs and arms, large hands and feet, short trunk, and face large in comparison to the head (the meso-onto-morphs) and those who were either tall and slender, or small and delicate, with the smaller face, eyes close together, long, high, narrow nose, and trunk longer as compared with the extremities (the hyper-onto-morphs). Bean showed, too, that the hypers (to use a short word to contrast with the mesos) were present to the extent of almost a hundred per cent in a series of tuberculosis, and about ninety per cent in a series of central nervous system disease. All of which is exceedingly interesting and suggestive, but throws no light upon the underlying mechanisms of statures.

STATURE AND GROWTH

Stature is essentially determined by the growth of the long bones. They are the pace-makers, and the muscles and soft tissues follow the pace they set. Now the primary determinant, catalyst or sensitizer of the growth of the long bones is the anterior pituitary. All statures should therefore be first scrutinized from the point of view of the pituitary. Individuals over six feet tall or under five feet five inches should be looked upon as having a pituitary trend. This pituitary trend may be primary, due to its own undergrowth or overgrowth, or it may be due to lack of inhibition from the sex glands such as occurs in eunuchs and eunuchoids, or excessive or premature inhibition from them as happens in certain salacious dwarfs.

The long bones grow at a point of junction between the bone proper and an overlying layer of gristle or cartilage, known as the zone of ossification. It is upon this zone of ossification that the various growth influences appear to focus and concentrate their efforts, among them the internal secretions. After growth has been finished, that is, after adolescence, these zones of ossification close, so that growth is no longer possible unless they become reactivated. Upon the zone of ossification must act the pituitary, and indirectly the thyroid, the interstitial cells, the thymus and the adrenals. Individuals oversized or undersized either belong to the pituitary type, or if hyphenated, have the pituitary as one of the dominants in their composition. The necessities of child-bearing determine a greater angle between trunk and lower extremities in the female. Underactivity of the pituitary, for instance, will prevent the development of the normal angle. The ratio in length of the upper limbs to the lower is a fairly constant relationship for each sex normally Deviations occur with a break somewhere in the chain of cooperation of the internal secretions controlling the growth of bone.

HANDS, FINGERS AND TOES

The size and shape and general configuration of the hands, fingers and toes are details that tell an endocrine tale. Students of hands naturally have grouped them as the long slender and the short, broad, the bony and the well-filled out, the tapering fingers and the stumpy. The character of a hand is determined anatomically by the length and breadth of the bones, the amount and distribution of fat, and the thickness and elasticity of the skin. Over these, the essential control lies in the pituitary and the thyroid. So we find that pituitary types have, when there is oversecretion, large bony, gross hands, spade-shaped, or when there is undersecretion, hands that are plump, with peculiarly tapering fleshy fingers. The hyperthyroid has long slender fingers, the subthyroid pudgy, coarse, ugly foreshortened hands, often cold, and bluish.

FACIAL TYPES

An artist will see in a face the past history of generations, a narrative of the adventures of the blood, a record of tears and smiles, wrinkles and dimples, the victories and defeats of buried drudgery and romance. These signatures which the Faculty of Life have scribbled or engraved over it as upon a diploma, bespeak for him spiritual moments. To the student of the internal secretions the lines, expressions, attitudes are important for they tell of the state of tensions and strains in the vegetative apparatus with which they are inseparably connected. It is when one comes to the consideration of the face as a complex of brows, eyes, nose, lips and jaws that he becomes most interested. For in the modeling and tone of every one of the features each of the endocrine glands has something to say. In consequence there has been described the hyperpituitary face, and the hyperthyroid face, the subthyroid face and the subpituitary face, the adrenal face, the eunuchoid face and the ovarian face and also the thymic.