The Glands Regulating Personality - Louis Berman, M.D.
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Pituitrin is a substance of many marvelous functions. In general, it
controls the _tone_ of the tissues, of involuntary or smooth muscle
fibres of the blood vessels and the contractile organs of the body
like the intestines, the bladder and uterus. When injected, it will
slowly raise the blood pressure and keep it raised for some time, and
will increase the flow of urine from the kidneys and of milk from the
breasts. It will also cause an intense continued contraction of the
bladder and the uterus. It is also said to control the salt content of
the blood upon which its electrical conductivity and other properties
depend. Normally, there is a certain fixed ratio of the salts in the
blood, which keeps them like the ratio in sea-water. Again, we have
an example of the curious atavism of the internal secretions. The
thyroid, remember, keeps the iodine concentration of the blood like
that of the ocean, our original habitat. Pituitrin likewise does its
part to maintain our internal environment as near as possible to what
was once the surrounding medium. A substance somewhat similar has been
found in the skin glands of toads.
The extraordinarily well protected position of the pituitary, its
persistence throughout life, and its abundant blood supply, emphasize
its vital importance. No other gland of internal secretion can
adequately substitute for it. Complete expiration means death, in two
or three days, with a peculiar lethargy, unsteadiness of gait and loss
of appetite, emaciation, and a fall of temperature, so that the
animal becomes cold-blooded, its temperature the same as that of the
atmosphere it occupies. If only part of the anterior lobe is taken
away, there occurs a remarkable degeneration of the individual. The
degeneration is not a mucinous infiltration of the skin and the
internal organs which occurs with thyroid deprivation, but a fatty
degeneration, with a tendency to inversion of sex. A singular
somnolence, a dry skin, loss of hair, a dull mentality, sometimes
epilepsy, and a noticeable craving for and tolerance of sweets appear.
These are but a few of the observations obtained in experimental
sub-pituitarism, that is, underaction or insufficient secretion of the
pituitary, produced by removing part of the anterior gland.
If such an experimental sub-pituitarism is started in infancy, for
instance in puppies, there is a cessation, or marked hindering and
slowing of growth. That is, dwarfs are artificially created. Apropos,
pathologists have shown that in several true human dwarfs the gland
is rudimentary or inadequate. All of which goes hand in hand with the
evidence that the skeleton stands directly under the domination of the
pituitary.
REGULATOR OF ORGANIC RHYTHMS
There are certain other singular by-effects of the gland in its
relation to the periodic phenomena of the organism like hibernation,
sleep, and the critical sex epochs of both sexes. In hibernation, or
winter sleep, the animal in cold weather passes into a cataleptic
state in which it continues to breathe, more deeply but more slowly
than when awake, but shows no other signs of consciousness or life.
A lowered blood pressure and a marked insensitivity to painful and
emotional stimuli go with it. There is a preliminary storage of starch
in the liver, and of fat throughout the fat depots of the body. These
are so like what happens after part of the pituitary is removed, that
a comparison of the two becomes inevitable. Common to both conditions
is a drop in the rate of tissue combustion or metabolism, which can
be relieved by injection of an extract of the pituitary, a rise of
temperature occuring simultaneously. Moreover, examination of the
glands of internal secretion of hibernating species, like the
woodchuck, during the period of hibernation, shows changes in all of
them, but most marked in the pituitary, the shrunken cells staining
as if they too were asleep, or in a resting stage. The characteristic
alive qualities of these cells return, without relation to food
or climate, when the animal comes to in the spring, at the vernal
equinox. Hibernation may, perhaps, be put down to a seasonal wave of
inactivity of the pituitary gland.
Now winter sleep may be looked upon as an exaggeration of ordinary
night sleep, the latter differing from the former only in its brevity.
In the natural sleep of non-hibernating species there occurs, too,
a fall in temperature. Moreover, they all, even man, have a certain
capacity for winter sleep, as the experiences of travellers and
explorers in the arctic regions indicate. In certain parts of Russia,
where there is a scarcity of food during the winter months, the
peasants pass weeks at a time in a somnolent state, arousing once a
day for a scant meal. Just as the sex glands influence the body and
mind profoundly with a certain cyclic periodicity of activity and
inactivity (rut, heat, menstrual period and so on), which has been
demonstrated to have a very close functional relationship with the
pituitary, so sleep and hibernation will bear interpretation as
products of a temporary dormancy of the same gland. We have, then,
to set up in the place of Morpheus and Apollo, the new gods of the
internal secretion of a chemical-making bit of the brain, as an
explanation of the rhythms of sleep and wakefulness.
There are individuals who go about outside of hospital walls,
quasi-normally, who are semi-hibernators or partial hibernators, and
who are really in a state of subpituitarism. They are people who may
have something wrong or inferior with their pituitary, but not to the
extent of interference with their daily life. They go about with their
type stamped upon them for the seeing eye. The classical type is
obese, with fat distributed everywhere, but more so in the lower
abdomen and the lower extremities. They are slow and dull, and
sexually inactive, often impotent. They are sometimes tall, but most
often dwarfish, and may be subject to epileptic seizures. They recall
the picture of what happens to young dogs partially deprived of the
pituitary. Dickens delivered a perfect likeness of an extreme degree
of the condition in the Fat Boy of the "Pickwick Papers," whose
employment with Mr. Wardle consisted in alternate sleeping and eating.
WHEN THE PITUITARY OVERACTS
All grades of overaction of the pituitary exist. Then its peculiar
power to act as a stimulant to the growth of bone and the soft
supporting and connecting tissues like tendons and ligaments comes
into play. If the overaction or excess of secretion begins in
childhood or adolescence, that is, before puberty, there results a
great elongation of the bones, so that a giant is the consequence. Now
giants have always appealed to the imagination of the little man, and
have had all kinds of wonderful abilities ascribed to them by him. The
giants and ogres of folk-lore and fairy tales are favored with the
most extraordinary mental advantages. Direct and analytic acquaintance
with the giants of our own day, as well as a probing of their conduct
in the past, has shown that normal giants--persons of exceptional size
free from physical or mental deformities--are rare. There are people
with _hyper_-pituitarism who exhibit the highest mental powers. In
them is an increased activity of the posterior lobe in association
with enlargement and hyperfunction of the anterior, overgrowth is not
so marked, and the individual is lean and mentally acute. But the
ordinary giant is one in whom there is degeneration of the pituitary
after too much action of the anterior and too little of the posterior
glands. A tumor or disease process in the gland is most often
responsible.
If the overaction of the anterior happens after puberty, when the
long bones have set, and can not grow longer, a peculiar diffuse
enlargement of the individual occurs, especially of his hands and feet
and head. The nose, ears, lips and eyes get larger and coarser.
As these people are rather big and tall to begin with, the effect
produced is that of a heavy-jawed, burly, bulking person, with bushy
overhanging eyebrows, and an aggressive manner. For there is, too,
something distinctive about their mentality which has been as often
portrayed as those of the pathologic giant. Rabelais' most famous
character, Gargantua, belongs to the group. We recruit more
drum-majors than prime ministers from among these people. They
often suffer much from torturing boring headaches, and a consequent
despondency and feeling of hopelessness which colors gray the entire
spiritual spectrum. Up to a certain point these sufferers have a
remarkable alertness and capacity. When conscious of the malady, they
often meet it with a doggedly courageous optimism, which is another
characteristic, although women occasionally commit suicide.
In both the semi-hibernators who remind one of cattle, and in the
giant or acromegalic types who remind one of the anthropoid ape, there
develops a distinct diminution of sexual life. An abnormal process in
the anterior gland, whether of oversecretion or of undersecretion,
may interfere with the proper functioning of the posterior gland, the
secretion of which is tonic not only to the brain cells, but also to
the sex cells. Thus, young animals deprived of the pituitary will not,
if male, grow spermatozoa, nor ripe ova in the female. Moreover, the
feeding of pituitary increases sexual activity. In the case of hens,
this has been demonstrated to be about thirty per cent by a pretty
experiment. At a time of the year when eggs diminish, six hundred
and fifty-five hens laid two hundred and seventy-three eggs upon an
ordinary diet. When pituitary was added to their food for four days,
the number of eggs rose to three hundred and fifty-two, an increase of
seventy-nine. In addition, the fertility of the chicks born of these
eggs was augmented, especially if both parents had been fed on
pituitary. There are other aspects of the relation of the pituitary to
sex, which will be treated in another chapter.
THE BONY CRADLE OF THE PITUITARY
Always, in attempting to understand the pituitary, it is necessary to
remember that it is tightly packed in the bony cradle, the Turkish
Saddle or Sella Turcica. Should some stimulus, local, or in the blood,
arouse the gland to growth, a good deal will depend upon whether it
has room to grow in, or it will make room by eroding the bone. With
space for the formation of a large anterior and posterior pituitary
gland, there will be created the long, lean individual, with a
tendency to high blood pressure and sexual trends, great mental
activity, initiative, irritability and endurance. An outstanding trait
of these favorites of fortune is that they remain thin no matter how
much food they consume, and they have the best of appetites. They
often are subject to severe headaches because of intermittent swelling
of the gland against the bone of its container.
If the bony container is or becomes too small for its contents, it
is interesting that along with the other signs of pituitary
insufficiency, such as undersize, obesity, and asymmetry, there
developes conspicuous moral and intellectual inferiority. The
unfortunates suffer from compulsions and obsessions and lack
inhibitions. They are the pathological liars with little or no
initiative or conscience--amoral, not merely theoretically, but
instinctively and unconsciously, with all the certitude and perfection
of the unconscious accomplishment.
THYROID AND PITUITARY
The thyroid and the pituitary have often been compared. The anterior
gland and the thyroid arise from almost the same spot in the embryonic
oesophagus, the thyroid being an outgrowth in front, the anterior
pituitary an outgrowth behind of the same soil. They both control
growth marvelously, also the differentiation, the mass and intricacy
of the tissues. But they differ in the site of their control. The
thyroid bears more directly upon the inner and outer coverings of the
body, the skin, the skin glands and the hair, the mucous membranes,
and the irritability and the preparedness for response of the nerves.
The pituitary acts more upon the framework of the body, the skeleton
and the mechanical supports and movers. Bone and ligament, muscle
and tendon seem to be within its immediate sway. The secretion or
secretions of the pituitary diffuse directly into the fluid bathing
the nervous system, supplying beneficent stimulants and aiding in the
abstraction of harmful waste. So while the thyroid raises the energy
level of the brain, and the whole nervous system, as a byproduct of
its general awakening effect upon all the cells of the body, the
pituitary probably stimulates the brain cells more directly, perhaps
in the manner of caffeine or cocaine.
The difference between the thyroid and the pituitary might be put this
way: that while the thyroid increases energy evolution and so makes
available a greater supply of crude energy, by speeding up cellular
processes, the pituitary assists in energy transformation, in energy
expenditure and conversion, especially of the brain, and of the sexual
system. In short, the thyroid facilitates energy production, the
pituitary its consumption. The pituitary appears therefore as the
gland of continued effort. Hence fatigability, an inability to
maintain effort, is one of the prominent complaints when there is
destruction or an insufficiency of it for one reason or another. As
such, it contrasts with the glands of emergency effort, known as the
adrenals.
CHAPTER III
THE ADRENAL GLANDS, THE GONADS, AND THYMUS
Like the pituitary, each adrenal gland is a double gland, that is,
consists of two distinct portions, united together, one might say, by
the accident of birth. It would be confusing, however, to speak of
each as two glands, because there are, as a matter of fact, two
separate adrenal glands, one in the right side of the abdomen, and the
other in the left. Each gland is composite, or duplex. How the two
parts came to be united is a long story, interesting but too long to
be recounted here. In fishes they are apart and independent.
Each adrenal is a cocked hat shaped affair, astride the kidneys,
easily recognized because of its yellowish fatty color. Indeed, for
centuries the glands were not given a separate status as organs, but
were passed up as part of the fat ensheathing the kidney. In childhood
and youth, in common with the other glands, they are relatively larger
and more prominent than in the adult. Also, at every age, the amount
of blood passing through them is very large compared to their size.
Their tremendous importance in the body economy accounts for their
being so favored.
The two parts of which each gland is composed, are known as the cortex
or outer portion (literally the bark) and the medulla or inner portion
(literally the core). No clean-cut boundary sharply delimits the two,
as strands and peninsulas of tissue of one portion penetrate the
other. In the history of their development in the species and the
individual, and in their chemistry and function, a sharp difference
contrasts them.
In the embryo, the cortex is derived from the same patch that gives
rise to the sex organs, the ovaries in the female, and the testes in
the male, described as the germinal epithelium. How intimately the
two sets of glands are connected is neatly pointed by this fact of a
common ancestor. All vertebrates possess adrenal glands. In the lowest
of the vertebrates, Petromyzon, the two parts are distinct, the cells
of the cortex-to-be are situated in the walls of the kidney blood
vessels, projecting as peninsulas in the blood stream, the blood
sweeping over and past them. The medulla-to-be consists of cells
accompanying the vegetative nerves. Among reptiles, the two become
adjacent for the first time, and among birds one part occupies the
meshes of the other. The size of the cortex varies directly with the
sexuality and the pugnacity of the animal. The charging buffalo, for
example, owns a strikingly wide adrenal cortex. The fleeing rabbit,
on the other hand, is conspicuous for a narrow strip of cortex in its
adrenal. Human beings possess a cortex larger than that of any other
animal.
No definite chemical substance has as yet been isolated from the
cortex. That remains a problem for the investigator of the future. But
certain observations, especially concerning the relation between
the development and behaviour of the so-called secondary sex
characteristics, those qualities of skin, hair and fat distribution,
physical configuration and mental attitudes, which distinguish the
sexes, and the condition of the gland, indicate clearly that an
internal secretion will be isolated, and that it will in its activity
furnish certain predictable features.
Three different layers of cells, arranged in strings, that
interpenetrate to form a network directly bathed by blood, that breaks
in upon them from _open_ blood vessels, compose the cortex. Most
remarkable is this method of blood supply for it is exceedingly common
among the invertebrates and rare among the vertebrates.
In certain disturbances of these glands, especially when there are
tumors, which supply a massive dose of the secretion to the blood
presumably, peculiar sex phenomena and general developmental anomalies
and irregularities are produced. If the disease be present in the
fetus, taking hold before birth, and so brought into the world with
the child, there evolves the condition of pseudo-hermaphroditism. The
individual, if a female, presents to a greater or less extent the
external habits and character of the other sex. So that she is
actually taken for a man, although the primary sex organs are ovaries,
often not discovered to be such except when examined after an
operation or death. How closely such an occurrence touches upon the
problems of sex inversion and perversion comes at once to mind.
If the process involving the adrenal cortex attacks it after birth,
the symmetrical correspondence and harmony of the primary sex organs
and the secondary sex characters are not affected. But there follows
a curious hastening of the ripening of body and mind summed up in the
word puberty, a precocious puberty, with the most startling effects.
A little girl of 2, 3, or 4 years of age perhaps will come to exhibit
the growth and appearance of a girl of 14. She begins to menstruate,
her breasts swell, she shoots up in height and weight, sprouts the
hair distribution of the adult, and the mentality of the adolescent,
restless, acquiring, doubting, emerge. A tot bewitched into puberty!
A boy of six or seven may suddenly, in the course of a few weeks or
months, become a little man, robust, rather short and stocky, but
moustached, with the muscular strength and sexual powers of a man and
thinking as a man. It is all as if into some fermentable medium or
solution a little yeast were dropped that changed the quiet calm of
its surface into a bubbling, effervescing revolution. It suggests at
once that maturation, the transformation of the child into the man or
woman, must be due to the pouring into the blood and the body fluids
of some substance which acts like the yeast in the fermentable
solution. The adrenal cortex is one source of the maturity-producing
internal secretions.
If trouble in the adrenal cortex starts after puberty, phenomena of
the same type, but of a different order, exhibit themselves. A woman,
say in the thirties, becomes thus afflicted. Slowly or quickly her
body will be covered by an abundant growth of hair, more or less of a
beard and moustache appear upon the face, her voice will become deep
and penetrating, her muscles will harden, and she will show a capacity
for hard physical labor. Sexually she appears to be made over,
masculinity now predominates in her make-up. Virilism is the name by
which the French in particular have popularized the knowledge of the
condition. Virilists have to shave or be shaved regularly and are not
bothered in the least by the cares, responsibilities, jealousies and
anxieties of personal beauty, for the change in their spirituality
makes them immune to the preoccupations of the feminine. The cause of
such a transformation in a previously entirely normal woman has been
found to be a tumor of the adrenal cortex.
But not only is sexuality, and the conduct of the secondary sex
characters, connected with the adventures of the adrenal cortex. The
development of the master tissues of the body, the brain, the pride
and darling of evolution, is in some subtle way correlated with
it. The adrenal cortex contains more of the phosphorus-containing
substances of the general nature of those found in the central nervous
system than any other gland or non-nervous tissues in the body. During
human intrauterine life the adrenal glands are large and conspicuous,
in the first half of the second month being twice as large as the
kidneys. Most of this relatively huge size, which happens in the human
alone, and not in other animals, is due to enlargement of the cortex.
Should this preponderance of the cortex over the medullary portion not
occur in the human, that is, if the proportions remain like those of
other animals, the brain fails to develop properly, or an entirely
brainless monster is generated. The human brain, therefore, probably
owes its superiority over the animal brain, to the adrenal cortex, in
development anyhow. The growth of the brain cells, their number and
complexity is thus controlled by the adrenal cortex.
Besides its action upon the sex cells and the brain cells, the
internal secretion of the adrenal cortex acts upon the pigment cells
of the skin, blunting their sensitiveness to light. In degeneration
of the interior of the gland, which destroys the medulla, but not the
cortex, the color of the skin is left unmodified. If, however, the
cortex is invaded, as happens most often in the classical tuberculosis
of the adrenals which drew the attention of the Englishman Addison
to them, then a darkening of the skin, which may go on to a negroid
bronzing, follows. That means an increased sensitiveness of the
pigment cells of the skin to light. Skin color control may therefore
be looked upon as an adrenal cortex function.
So much is known about the adrenal cortex. Upon the medulla, the
interior gland of the gland, there has been lavished an amount of
attention beside which the cortex is to be classed as a neglected
wall-flower. Nearly everything that possibly could be determined
about an internal secretion has in its case been settled or plausibly
guessed at. The cells manufacturing the secretion, its exact chemistry
and function, its action upon the blood, the liver and spleen, the
heart and lungs, the brain and nervous system, have been minutely
investigated, studied and charted. Its source in the food, its fate in
the body, its place in the history of the individual and the species,
its importance as a weapon in the struggle for existence, and the
survival of the fittest have been made the subject of an astonishing
number of researches, considering the short period of scarce three
decades that intensive science has centered its barrage upon it.
In the first place, the medulla contains numerous nerve cells,
belonging to the vegetative, also called the sympathetic nervous
system. But these nerve cells are merely minor notes of the symphony.
The motif is settled by a majority of large, granular cells, which
stain a distinctive yellowish-brown when the gland is fixed in a
solution of bichromate of potash. All chromium salts, in fact, stain
the therefore labelled chromaffin cells. The characteristic staining
power appears to be dependent upon, or correlated with, the presence
of the internal secretion of the medulla of the adrenal, adrenalin.
For the content of adrenalin, as calculated chemically, and the
depth of stain as seen under the microscope, rise and fall together.
Chromaffin reaction and adrenalin content go together. The poisonous
skin glands of the toad have been found to give a marked chromaffin
reaction, and to contain a large amount of adrenalin. Other masses
of cells in the human body, especially along the course of the
sympathetic nervous system, have been shown to give the reaction and
to contain adrenalin.
The erratic Brown-Sequard pounded and hammered away for more than
thirty years on the importance to life of the adrenal glands, since
death occurred so quickly after their removal. But it was not until
Schaefer, the Scotch physiologist, (who has done more than any other
living man to stimulate study of the internal secretions) found that
an extract of them, when injected into a vein, produced a remarkable
though temporary rise of the blood pressure, that a real enthusiasm
for its investigation was generated. As the upshot, a number of other
significant properties besides the first of blood-pressure raising,
have been put down to its credit. Chemical tests demonstrated that
it originated in the medulla. The exact amount of it present in the
medulla, in the blood issuing from the adrenals and in the circulation
in general have been determined. The concentration in the blood is
about one part in twenty million, while there is about a hundred
thousand times as much stored in the gland as reserve. In infections
and intoxications, after muscular exertion, and with profound
emotions, there is a decrease of it in the gland and an increase in
the blood. Pain and excitement, especially fear and rage, will bring
about its discharge from the gland. With its entry into the blood,
there is a tremendous heightening of the tone, a _tensing_, of the
nervous system. The nerve cells become more sensitive to stimuli,
more sugar is poured into the blood from the liver, more red blood
corpuscles are squeezed into the circulation from the blood lakes of
the liver and spleen. There is a redistribution of the whole blood
mass, a good deal of it being withdrawn from the internal viscera, and
hurried to the skeleton muscles and the brain. The heart beats more
strongly, the eye sees more clearly, the ear hears more distinctly,
and the breathing is more rapid. The temperature rises, the hair of
the head and the body becomes erect, the skin gets moist and greasy.
It will help a fatigued muscle to regain its normal tone. In short, it
has a reinforcing action upon the nutritive properties of the blood,
the tone of the muscles, and the activity of the brain and the
vegetative nerves.