A certain hocus-pocus concerning character reading, a perverted revival of the ancient phrenology and physiognomy, has invaded the employment territory in America as the newest charlatanism. The study of the internal secretions, including blood and X-ray examinations, will surely assist the demand for a truly scientific estimate of constitution and character that can be relied upon in the classification and distribution of personnel.
THE PROSPECTS FOR PUBLIC HEALTH
By their effects upon the endocrines, public health influences like food, clothing, sleep and overpressure and last but not least, disease, the so-called diseases of childhood, possess a tremendous importance in limiting the output of the educable. They act to subtract from and so to lower the rating, the capacity of the germ-plasm. Most material and vital of these influences are the common diseases of children, for they strike directly at the glands of internal secretion.
Measles, scarlet fever, diphtheria, mumps, and the others have long been accepted as providential visitations for sins known or unknown. That children had to have them and were better off when they had them has become part of the tradition of the laity, fostered by the lazy ignorance of previous medical generations. But today we are beginning to ask ourselves why children must have these endemic infections of their age. The pathologist goes farther and asks the reason for certain apparent immunities. He asks why the little boy who sleeps with his brother sick with scarlet fever does not contract the disease, even though not protected by a previous attack.
Determining why susceptibility to a special disease in a particular case exists will constitute the greatest line of advance for the understanding and prevention of disease, and so the perfection of public health. In the last influenza epidemic countless physicians were puzzled by the spectacle of men and women in the pink of condition carried off in twenty-four hours while puny associates were either passed over, or pooh-poohed their colds. Pathologists have spent their energies fruitfully upon the infectious causes of disease, the microbes and parasites especially. But now, having solved most of those problems, the vital question of why an organism permits itself to be attacked is pushing itself to the front. Why a peculiar ailment selects its victim, why the bacillus finds a fertile soil, is the neglected problem, which must be solved before the abolition of disease and its carriers will be remotely conceivable.
Long ago, Hippocrates, revered founder of the art of medicine, recognized that there was a specific affinity of disease for individuals with more or less the same characteristic somatic and psychic traits and trends. Tuberculosis, for instance, was noted for its frequency in long-skeletoned, thin persons, remarkably optimistic. And the plethoric, choleric nature of the sufferer from gout has become proverbial. Before the era of the great bacteriologic discoveries of the eighties and nineties, the concordance of esoteric racial and personal markings was a great help in diagnosis to the physician. For he realized, though he sometimes credited it to his clinical intuition, that it was a certain type of personality that was liable to the specific disease.
But personality and its reactions, normal and abnormal, are determined by the endocrines. So we should find that particular infections run with special internal glandular predominances. For the picture presented by an infection, temperature, rash, prostration, are the details of the general reaction of the organism in the face of a new situation, the presence of a powerful, destructive invader. Information has accumulated that the invader is powerful and destructive, as well as selective, because of endocrine deficiency of one sort or another in the body it has attacked. Work of a number of investigators has indicated that an individual's susceptibility or its reverse, resistance, is intimately subjected to the derangements or harmonies of the endocrine system.
Comparison of the endocrine type and the disease assaulting has yielded an even more interesting principle. Knowing the state of the internal secretion reservoirs enables us to predict the liability to certain of these infections of childhood. Diphtheria has been found to occur most virulently among adrenal poor individuals. Moreover, they are left poorer in adrenal afterwards. It follows that they would be assisted by the feeding of adrenal. Mumps is a sickness that sometimes permanently injures the gonads: the testes or ovaries. The thyroid dominant, whose system is rich in thyroid, will rarely suffer from any of the common diseases of children—if at all, from measles. Op the other hand, those who have every infection of the period, and who, as their mothers say, seem to get everything, are those whose system is thyroid poor. Thyroid poverty is a splendid enticement to the universal microbe. The thymocentric stands all diseases poorly. The pituitary type is more liable to epidemic meningitis and infantile paralysis, typhoid and scarlet fever.
The public health officer of the future will be armed with a new weapon in his fight against the spread of an epidemic. He will be able to classify the endocrine traits of the population exposed, and to advise a course of glandular feeding for the types specially liable. The Schick test for diphtheria susceptibility is an illustration of one method of approach to the problem of the epidemiologist in settling who needs protection. The endocrines will assist him in the great body of diseases for which no immunity test is at hand. Should another influenza epidemic come along, for instance, the proper handling, from the endocrine standpoint, of the thymocentrics and the related adrenocentrics would help considerably in lowering the mortality.
Endocrine types have other tendencies, which when studied and controlled, will decimate the great assassins of middle age: heart disease and kidney disease, with accompanying degenerations of the blood vessels and circulation. The adrenocentric tends to get up a hyperacidity of the stomach and a high blood pressure, besides certain forms of diseases of the lungs. The thyrocentric is predisposed to heart disease, as well as intestinal disturbances. The pituitocentric is liable to periodic and cyclic upsets in his health.