The Internal Secretions in Practical Medicine

. The thyroid gland has been aptly called "the keystone of the endocrine arch"; and we are beginning to realize that the glands of internal secretion play a much more important role than many of us had hitherto imagined. In fact, they are the prime factors in the regulation of metabolism; dominate the nervous system, more especially the sympathetic; and are altogether indispensable to the maintenance of the physiologic harmony of the body. Our interest in these glands, then, by no means should be limited to the mere consideration of definite disease in one or more of them. We should seek rather to appreciate the insidious and insignificant minor aberrations from the normal, and in so doing in many cases we will be able to forestall the more serious organic manifestations which later assert themselves. (My use of the word "in- Read before the Riverside County Medical Society, December 13, 1915, and reprinted from the California State Journal of Medicine (San Francisco), May, 1916. significant" refers rather to the ease with which these conditions are appreciated, than to their comparative importance, for these aberrations are certainly much more important than yet appears to many physicians.) As we occupy ourselves in searching for the early, minor manifestations of internal secretory disturbance, we will be able not merely to forestall the more serious organic diseases, but will discover that unsuspected associated symptoms, from chilblains to nocturnal e...