The Glands Regulating Personality - Louis Berman, M.D.
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The history of a cretin runs somewhat as follows: A baby is born,
which in all appearances seems normal. Perhaps the nose is a trifle
squatter than even the average new-born's flat nose. There may also be
abnormal sleepiness, greater even than that of the normal baby in the
first month or two in that there is no spontaneous awakening from
the coma for food. But in most cases this is put down to normal
variability, or maybe to that limbo of all a baby's troubles:
weakness. After some months, it is noticed that the infant is failing
to grow at the normal rate, either physically or mentally. Examination
at this time reveals a curious thickening of the dental ridges. Then
the tongue takes the centre of the scene, by becoming unusually thick
and prominent, to the point of projecting beyond the mouth at all
times, and interfering with breathing, when the infant is in a
recumbent position.
More and more of the characteristics of the affection turn up. The
queer, repulsive, pitiful face of the cretins, which makes them all
seem brothers or twins, shapes itself. A yellowish, white or waxy
pallor; rough, dry, scaly, bloated skin; swollen, often wrinkled brow;
watery eyes, often almost concealed by the thickened eyelids; the
depressed pug nose with its wide, thick nostrils; large, erect ears;
the wobbly, drooling tongue, sticking out at one, yet not in derision;
the hair thin, and like tow in texture rather than human; eyebrows
and eyelashes are scant, and often absent; the nails short, thin and
brittle; the teeth, very late in coming, may be represented by a few
sharp points, irregular, decaying quickly, sometimes not succeeded at
all by those of the second dentition.
Whatever growth occurs is irregular and disproportionate. The trunk,
though small compared with the head, appears massive against the
background of the diminutive extremities. The back is somewhat humped,
arching at the waist-line, while the abdomen protrudes like a balloon,
with a hernia, often, at the navel. The extremities are short, bowed,
cold, and livid, covered with rolls of the infiltrated skin, rolls
which cannot be smoothed out. Hands and feet are broad, pudgy, and
floppy, the fingers stiff, square and spade-like, the toes spread
apart, like a duck's, by the solid skin. Above the collar bones there
are frequently great pads of fat which sometimes encircle the narrow
bull neck.
The mental state varies with the degree of deprivation of the internal
secretion of the thyroid. In the worst cases it is repulsively
vegetable. Even the intelligence common to the higher animals is
wanting. The cretins of the "human plant" kind, as they have been
nicknamed, will not recognize mother or father or any person about
them, or even a person from an object, and manifest no interest in
anything or anybody, not even toys. Hunger and thirst they manifest by
grunts and inarticulate sounds, or by screaming. They neither smile,
cough, nor laugh, but sit like sphinxes, breathing, but not reacting.
There are, of course, all grades and varieties. There are those who
recognize parents and familiar faces, and exhibit some evidence of
affection for them, acquire a limited vocabulary, and then cease, no
progress possible even with the alphabet. They attain the size and age
of two or three years and there stop altogether, as if a permanent
brake were applied to the wheels of their growth. Some higher types
may even come to speak connected sentences, and exhibit a certain
mild spontaneity, though stupid and slow and abnormally deliberate,
resembling the acquired form of thyroid deprivation or insufficiency,
for which Ord invented the name myxedema.
I have filled in with some detail this thumbnail sketch of thyroid
deprivation as it occurs in infancy to illustrate how wide a sweep the
gland's lariat embraces. Skin, hair, bones, muscle and fat, brain and
intelligence, growth and development, are modified precisely as the
size and shape of certain crystals are modified by the presence or
absence of ingredients in an apparently homogeneous solution. A
fertilized ovum, in which the predecessor of the thyroid gland is
present, that is to say, in which there is the seed and soil for its
sprouting, looks the same as one without that formative material. Yet,
when the time comes for the internal secretion of the thyroid to put
in its oar in the metabolic game, its presence or absence makes all
the difference in the world to the individual.
In the middle of the nineteenth century, when the concentration of
phosphorus in the brain was established as significant, the cry for
the emphasis of that fact was--without phosphorus no thought is
possible. We can much more relevantly declare that without thyroid,
no thought, no growth, no distinctive humanity or even animality is
possible. For the epigram about phosphorus was bombast, since it can
be declaimed with equal truth that without oxygen, without carbon,
without nitrogen, without any of the food elements that go to make
up the chemical composition of brain matter, no thought is possible.
Indeed, if one were set upon the indictment of a single chemical
element as the begetter of consciousness, the prisoner at the bar
would have to be copper. There is more copper in the brain by a
considerable degree than in any other organ of the body. Which perhaps
will be exceedingly regretted by the patrons of the aristocracy of the
soul who would have it as an emanation of a deposit in the brain of
silver at least, if not gold. They are like the old lady who would
never permit herself to be cured of her ailments except by gold plated
pills. Copper, however, is not necessary to intelligence. Without
thyroid there can be no complexity of thought, no learning, no
education, no habit-formation, no responsive energy for situations,
as well as no physical unfolding of faculty and function, and no
reproduction of kind, with no sign of adolescence at the expected age,
and no exhibition of sex tendencies thereafter.
EFFECTS OF FEEDING THYROID
How subtly the internal secretion affects every phase and aspect of
child as well as adult, by doing something to the speed of activities
in their cells, is told straightway by the effects of it when eaten
or introduced into the skin or blood of various people. A cretin,
idiotic, dwarfish, deformed, hopeless, an incessantly prodding burden
of sorrow to the mother, who looks upon the masterpiece she had
labored to bring forth, and beholds a terrible gargoyle, becomes
transformed when fed thyroid.
In a few days the cretin will get warmer, and require much less
wrapping and bed-clothing. With the improvement in circulation, the
color becomes better and the extremities lose their coldness. In a
week or so, irritability and resentment at disturbance appear. He will
begin to recognize and know his parents, smile and play. There is
a gradual return to the normal of the facial appearance, and a
resumption of growth. All kinds of marvelous growth effects occur.
Twenty teeth may be cut in six months. Coarse, rough dry, shaggy hair
becomes fine, silken, long and curly. The skin becomes soft, moist and
roseate. Inches in height may be added every month. Bright, active,
even talkative, are the descriptive terms an observer would apply
after a few months. A complete remaking of body and soul is apparently
affected.
Yet, should the administration of the thyroid cease, an almost
immediate reversion to the original vegetative condition is
inevitable. After a few days, reactiveness slows down, the child will
speak only when spoken to, will sit quietly in a chair all day and
act semi-anesthetized. Gradually hair and skin return to the previous
cold-blooded animal state, and the whole picture of the cretin is in
full bloom. Supplying the internal secretion of the gland promptly
repeats the transformation.
One wonders what is to be the ultimate fate of these reformed cretins.
Since the tale of the opening of life to them, once considered
hopeless idiots, is scarce a generation old, we have no data, as
yet, as to the character of their children or grandchildren, their
adventures and vicissitudes, in short, their life history. Those of
whom we have any record are normal and healthy school children or
workers, alive to the interests of childhood or their occupation
and social circles. No one outside their family knows that they are
cretins, and the most acute observer would be hard put to it to
suspect. What a theme for the reflections upon appearances the eminent
Victorians loved!
There are possibilities the imagination may envisage. One may suppose
such a cretin, with all his other ductless glands intact, grown
successfully to manhood under careful medical guidance. No one but
himself is aware of his affliction, outside of his medical advisers.
Luck aids him to rise in the world, or perhaps he has been born with
a spoon of the precious metals in his mouth. Adolescence, love and
marriage dance their sequence. Our hero of course keeps his dread
secret to himself. Whether such an omission of confidence would
entitle his wife to a divorce is something courts will be called upon
to decide sooner or later. But, without anticipating, the honeymoon
involves a trip to the South Seas. A storm and a wreck throws them
alone on an island, tropical, easy to live on, and rescue in the
course of a few months certain. The man, to his horror, discovers that
he has saved of his medicaments only a pill box containing half a
dozen of thyroid tablets, his requirement being one a day. He sees
them go day by day. Finally they are all gone. He feels his faculties
slipping hour by hour. Shall he tell her? Indecision grips him, and he
delays until the day when his consciousness sinks to the point where
his mind no longer grasps his problem. The wife must endure the
spectacle of the enchantment of her husband, and his change from
gallant lover to dull animal ogre. A new version of Beauty and the
Beast!
Cretinism as one manifestation of a soul without thyroid or without
enough thyroid is not all. The first great successes with thyroid were
achieved in adults, particularly adult women, exhibiting a peculiar
obesity, coldness, loss of hair and teeth and a remarkable lassitude
and torpor that might be summed up as a chronic drowsiness, like a
saturation of the blood with some narcotic drug. Or there may be a
melancholia, or a lack of ability to seize the finer points of a
mental process, or an argument treated in the abstract. Children
are said to be lazy, slow or dull. They experience an irritating
difficulty in understanding questions and expressing their wants and
desires, and so are declared to be vicious, or stupid.
All these are grades of the degeneration which Ord, the Englishman,
named myxedema. At its worst it is a sort of bloating and drying of
the body and the mind. Then there is infantilism, which is helped by
the giving of thyroid extract. It differs from the ordinary cretinism
in that, while one is reminded of the latter by the physical stunting
and the other stigmata, there is a certain amount of intelligence
which enables the individual to hold his own while he is a child. He
becomes a grown-up baby: at twenty prefers the company of children of
ten, and passes under the evil influence of designing so-called normal
persons. So dominated he will lie, steal, start fires, commit almost
any crime, with no inherent flair for criminality, but because of a
lack of independent judgment and inability to resist suggestion, and
a desire to please friends. He is simply an overgrown child who still
loves to play with toys, laughs and cries, becomes angry or afraid,
unreasonably and ridiculously, and yells for mamma when thwarted or
scared.
So much for what happens when there is not sufficient of the thyroid
secretion in the blood and tissues. Now to consider the effects of
an excess of it, the condition called hyperthyroidism, as the
insufficiency of it is labelled subthyroidism. Too much thyroxin can
be introduced into the system of a normal individual, or even a cretin
by the simple administration of too large doses or over too long
a time. Also a train of symptoms similar to those evoked by an
oversecretion of the thyroid may be mobilized by the taking of too
much iodine. Great sorrow, great joy, a sudden severe jolt to the
nervous equilibrium, sexual excitement, an overwhelming anger or grief
may leave in their wake a permanent hyperthyroidism. The symptoms are
the reverse of cretinism and myxedema. There is an over-excitability
of the nerves in place of sluggishness, and an over-reactivity of the
whole organism to its environment. The heart's action is too fast, and
under the slightest stimulus gets faster to the point of obtruding
itself into the conscious mind as a palpitation. Instead of the
lowered temperature and coldness of the cretin, there is a heightened
temperature, one or two degrees above the normal, and a feeling of
heat. The individual has a high warm color, does not sleep well,
becomes or remains thin no matter how much he or she eats, is
abnormally susceptible sexually, may suffer from a definite insomnia,
is emotional, and perspires freely. Alert, neurotic or high-strung,
magnetic, and imaginative are some of the descriptive adjectives
applicable. The eyes are bright and prominent, large and beautiful,
when they have not reached the stage entitled "pop-eyed." Or they may
even become so protuberant and bulging as to develop the expression of
one staring aghast at some ineffable horror. The latter is the feature
of only the severest types, when there is an associated goitre, the
combination designated as exopthalmic goitre.
There are, too, individuals in whom hyperthyroidism and hypothyroidism
are mixed, or rather alternate. At one time they present the phenomena
of the one, at another of the other. They are the people who complain
of the cyclic quality of their moods and purposes. Their mood will
be a heaven of exaltation and exhilaration, and then descend into a
slough of despond from which they feel themselves inextricable. They
are always talking about the ups and downs of their mental states.
Headache and languor and fatigability, dry skin and lack of appetite
for food or exertion on one day or for one week, give way on the next
day, or for the next week, to an energetic gayety, and sweaty, flushed
skin, a prominent appetite for food and every sort of activity. Driven
to be forever on the go, for one period, in the next they feel like
lying down most of the day, with no inclination for any life whatever.
The stage of depression may go as far as a melancholia, the stage of
stimulation as far as mania. They may simulate manic-depressive or
cyclic insanity. Something restrains them, and holds them bound as in
a vise in the one cycle. And then they are driven on beyond themselves
by some invisible whip in the next.
THYROID AS DIFFERENTIATOR
Besides the action of the thyroid as energizer, lubricator, and growth
catalyzer, it has a remarkable power as a differentiator of tissues.
It determines the embryonic etchings of the different organs which in
their totality comprise the unique individual. Every multicellular
animal must first have existed as a single cell, the impregnated ovum.
With the body and personality of the ovum, the creature is one and
continuous, literally something the single cell has made of itself by
sub-dividing and differentiating. In the process, the cell mass often
goes through stages which stand out as individualities in themselves,
that appear on the surface absolutely unrelated. So the caterpillar
and the butterfly, to the naive child, seem as far apart as worm and
bird. In the case of the frog, the tadpole as a first sketch seems
completely an impossible and wild absurdity. Yet we know that there is
an orderly progression of events, a propagation of cells, a forward
going arrangement of chemical reactions, that results in expansion and
intricate complication of the organism. Just what the forces at work
in this most mysterious of all natural processes are, has been an
intellectual mystery that the best minds of the race have attempted
to get rid of with words like pangenesis (Darwin). Words of Black
(Mediterranean or Greek and Latin) origin, as Allen Upward has named
them, always cover a multitude of ignorances. The glands of internal
secretion, here, as in so many other dark places, provide the open
sesame to certain long closed doors of biology. They offer themselves
to us as the first definitely tangible agents which are known to keep
the process of growth going, and undoubtedly initiate the marvelous
unfolding of tissues and functions, organs and faculties summed up as
development or differentiation.
Thus by the direct feeding of thyroid at particular points in the
differentiating history most curious effects have been elicited. If
the gland is made part of the nutriment, the bathing environment, of
the tadpole, a hastening of its metamorphosis is attained. The tadpole
lives not out its day as a tadpole, but precociously turns into a
frog. But such a frog! It is a miniature frog, a dwarf frog, a frog
seen by looking through the wrong end of the telescope, a frog not
magnified, but micrified. Frogs have been so created the size of
flies. There has occurred a splitting of the two reactions which
ordinarily go hand in hand: the reaction of growth which is just brute
increase of total mass or weight and volume, and the reaction of
differentiation which is the finer process. The picture is a frog, but
a frog the size of a tadpole, a frog which has missed its childhood,
adolescence and youth, skipping over these transition stages into the
adult age, as a pigmy.
It is all as if a baby were suddenly to grow a beard and moustache,
evolve and shed teeth, and acquire the manner of an earnest citizen,
and yet retain the height and weight of a baby. That the spectacle
of such a superbaby is not quite the most fantastic of all
improbabilities is shown by the condition of progeria, first recorded
by the Briton, Hastings Guilford. A queer spectacle in which a child
incontinently grows old without having lived--in the course of a few
weeks or months. You look upon him and see senility on a small scale,
but with all its peculiarities: wrinkled skin, apathy, gray hair and
all the rest of it. All we can say about it is that it is probably due
to a paralysis of all the glands of internal secretion, a removal
of their influence upon the cells. Contrariwise to the feeding of
thyroid, removal of the thyroid of tadpoles will prevent their
development into frogs. If iodine is then fed to them, say mixed with
flour, normal metamorphosis will occur. If Body is the tool chest
which we carry about with us, as Samuel Butler said, then to the
thyroid belongs the name of tool-maker.
Another function of thyroid that must be taken into consideration is
what has been spoken of as its antitoxic function--in plainer English,
its power to prevent poisoning, or to increase resistance against
poisons, including the bacteria and other living agents which
cause the infectious diseases. Each molecule of food, ingested for
assimilation into our substance, accumulates a history of wanderings
and pilgrimages, attachments and transformations beside which the
gross trampings of a Marco Polo become the rambling steps of a
seven-league booted giant. In the course of its peregrinations, it
becomes a potential poison, potential because it is never allowed to
grow in concentration to the danger point. The thyroid plays its role
of protector like all the internal secretory machines. In an animal
deprived of a thyroid the feeding of meat shortens life--a single
sample of how it works to guard against intoxication from within. The
feeding of thyroid will also raise the ability of the cells to stand
poisons introduced from without--intoxications of all sorts. Alcohol
and morphine will affect in much smaller doses the subthyroid person
than the normal or the hyperthyroid. As regards the infections, which
directly or indirectly kill most of us, the injection of thyroid will
increase the content in the blood of the protective antibodies which
preserve us, temporarily at any rate, against malignant invaders. The
opsonins, for example, those substances which butter the bacteria so
that the appetite of the white cells for them is properly roused, are
mobilized by thyroid feeding or injection. Other substances in the
blood which destroy and dissolve bacteria are also increased. The
thyroid probably performs these functions by sending its secretion
to the cells directly responsible for the immunity reactions, and
stimulating them to activity.
A sketch of the thyroid like the foregoing shows it as the wondrous
controller of vitality and growth, and indefatigable protector against
intoxicants and injuries. When it is sufficiently active, life is
worth while; when it is defective, life is a difficult threatening
blackness. That would make it out as the gland of glands. It is
tremendously important, without a doubt, in normal everyday life. But
no more so than the other members of the cast. The position of star it
may claim, but in vain. The other glands of internal secretion to
be sketched will each, when the marvels of its business in the
cell-corporation are considered, present itself as candidate for the
honors of the president. Justice should give fair credit to all
the organs which fabricate the reagents of individuality, and the
regulators of personality.
THE PITUITARY
In the human skull, the pituitary is a lump of tissue about the size
of a pea lying at the base of the brain, a short distance behind the
root of the nose. It is of a grayish-yellow color, unpretentious and
insignificant enough in appearance, and so long neglected by the
scientists who boast their immunity to the glamor of the spectacular.
Guesses at its nature date back to Aristotle.
Like most of its colleagues among the glands of internal secretion,
it is really two glands in one, two glands with but a single name. At
least it consists of two different parts, distinct in their origin,
history, function and secretions, but juxtaposed and fused into what
is apparently a homogeneous entity. They are conveniently spoken of as
the anterior gland and the posterior gland.
In the embryo, the anterior gland is derived by a proliferation of
cells from the mouth area. The posterior gland represents an outgrowth
of the oldest part of the nervous system. When it is traced back along
the tree of the vertebrate species, it is found to be present in all
of them. An ancient invention, its precursor has been identified in
worms and molluscs and even among the starfish. "The pituitary
is practically the same, from myxine to man." A trusted veteran,
therefore, among the internal secretory organs, its importance can be
surmised.
To understand the story of the pituitary, variously acquired bits of
information concerning it have been assembled and fitted together like
the fragments of a picture puzzle, as Cushing has so well put it. Here
and there pieces stick out, obviously out of place. The relations of
some of them to one another or to the whole design are not at all
clear. Parts appear to have been irrevocably lost, or not yet to have
turned up. Chance bystanders will select odd figures and articulate
them into a new harmony. Yet out of the jumble of fragments, a fairly
respectable insight has been gained in less than a half century.
The pituitary is cradled in a niche at the base of the skull which,
because of its form, is known as the Sella Turcica or Turkish saddle.
So situated, an operative approach to it is overwhelmingly difficult.
On the other hand, X-ray studies are favored. "Nature's darling
treasure" it might be called, since there has been provided a skull
within the skull to shelter it.
Under the most highly magnifying lenses of the microscope, three kinds
of cells have been distinguished. The anterior gland is a collection
of solid columns of cells, surrounded by blood spaces into which their
secretion is undoubtedly directly poured. A gelatinous material,
presumed to be the internal secretion of the gland, has, in fact, been
observed emerging from the cells into the blood spaces. The posterior
lobe, or gland, consists of secreting cells producing a glassy
substance which finds its way into the spinal fluid that bathes the
nervous system. The spinal fluid itself is a secretion of another
gland at the base of the brain, the choroid. Nerves and internal
secretion are associated here with a closeness symbolic of their
general relations.
From each portion of the gland (to stick to the accepted nomenclature
of speaking of the two glands as one) an active substance has been
isolated. Robertson, an American chemist, separated from the anterior
lobe a substance soluble in the fat solvents, like ether and gasoline,
which he christened tethelin. But P.E. Smith has shown that the active
material is soluble neither in boiling water nor in boiling alcohol,
the typical fat solvent. A number of facts favor the idea of the
anterior lobe cells as stimulants of growth of bone and connecting
and supporting tissues generally. From the posterior lobe, pituitrin,
believed its internal secretion, has been obtained in solution.