Access to all articles, new health classes, discounts in our store, and more!
The Association for the Study of Internal Secretions: Its Past, Its Future
Published in Endocrinology, Vol. 30, No. 6, June 1942, pp. 846 – 852.
* * *
Certain therapeutic products are particularly suited to the game of racketeers. Such are vitamins sold over the counter, advertised over the radio and in the newspapers, and allegedly added to various foodstuffs. The products of the endocrine glands are also particularly adapted to exploitation. When first they were brought to the attention of the public there was so much discussion and so much written about them in the press that demands were made for their therapeutic use long before products which were of value could be discovered.
It had been evident for some years that the internal secretions were sooner or later to become the object of intensive research. From the time Addison ascribed to the disease which bears his name a relationship to the adrenal gland, and diabetes was associated with disease of the pancreas, and myxedema was classed as being the result of a deficiency in the secretion of the thyroid, it was clear that the study of such diseases could not be delayed beyond the time when a suitable approach could be determined.
It seemed evident in the decade after 1910 that this time had apparently come. Moreover, it was desirable that such research be directed so that the public should be protected from charlatans who profit by making fraudulent claims. To this end the Association for the Study of Internal Secretions was pledged. It was organized in 1916. It developed and established high and what seemed almost impossible standards for endocrine products.
This Association was the first international society formed for the study of endocrinology. Fortunately for the organization and for the public, this association was controlled by medical men of high ideals. Among those who were especially active in its early guidance were Doctors Bainbridge, Barker, Cannon, Crile, Cushing, Daland, Dana, DeBuys, Goetsch, Hoskins, Hoxie, Kendall, Novak, Potts, Plummer, Sajous, and Timme. Dr. Hoskins, Editor of the Journal, Endocrinology, had the support of these men, insuring that the subject would not be exploited as a pseudoscientific affair.
As the years passed the Association secured the interest and gathered into its fold practically every scientific investigator in the field, and now has a galaxy of research workers rivaling those who gave bacteriology to medicine.
It was my pleasure to serve as Secretary of the organization during its formative years, and it was my honor to serve as its President after it had become well-established. At first it was a discouraging task to keep the Association going, because of the disappointment at the lack of effective products; in fact, when the Association was established there were only two dependable endocrine products available–thyroid gland substance and adrenalin.
It was impossible for endocrinological facts to be developed as fast as the public demanded, and this slowness came near wrecking our effort. Nevertheless, by appealing to the loyalty of the members of the medical profession and to their confidence in the future, and by working sympathetically with the manufacturers of biologic products, we were able to secure a cooperation to the end that the development of endocrinology was held on a high plane, and the public was protected.
Our problem was particularly difficult because the existence of the Association depended upon the support of clinicians who were being besought by their patients for help which they were unable to give: Accordingly there was more or less disappointment expressed by our members, not only by complaint but too often by resignation. This made the financing of the early years exceedingly difficult. It was necessary to make continuous appeals to the friends of our most interested members in order to fill our annually depleted ranks and keep the Association alive.
However, the leaders never lost faith that the future of the Association, could it survive, would be a glorious one; but they knew equally well that its future was precarious because of the constant uncertainty of survival. In order to meet deficits there were a few members who contributed generously, and finally, through the agency of Mrs. Stanley McCormick, a yearly grant was secured and was continued sufficiently long to put the organization on a sound business basis. This beneficence, the steadfastness of the inner circle, and Dr. Hoskins’ persistent effort held the Association together until a sufficient number of facts regarding endocrinology were discovered to make it a real power in medicine. Nor must the faithful work of Mr. P. C. Mason as Assistant Secretary and Business Manager during these years be underestimated.
Dr. Hoskins, and later Dr: Lee, made Endocrinology a Journal of which medicine can well be proud. Today, after twenty five years, we have a virile organization, publishing two journals, the one for reports from the laboratory, the other for clinical papers.
The Association has now made history, and its members may desire to know something of its past. So I will detail some of the incidents which marked its beginning and which, in case of need, may serve as its birth certificate.
The Association was founded by a group of men called together by Dr. Henry R. Harrower, of Glendale, California, at the Hotel Tuller in Detroit, June, 1916, at the time of the meeting of the American Medical Association. He had interviewed many men in different cities of the United States and gave it as his opinion that a sufficient number were interested in endocrinology to warrant the establishment of an association for its study. A Committee on Organization consisting of Doctors Lewellys F. Barker, Judson Daland, L. R. DeBuys, Emil Goetsch, Henry R. Harrower, George H. Hoxie, and John B. Potts, was appointed to report in New York City, in June, 1917, during the week of the next meeting of the American Medical Association. Dr. Harrower presented the names of three hundred charter members. Many of these, however, failed to become active when the organization was completed.
A program was given at the New York Children’s Hospital and School, at Randall’s Island, which was considered the first under the auspices of our Association. Three papers of a total of thirteen were devoted to endocrinology as follows.
- The influence of endocrine disturbances in the causation of feeblemindedness, with a presentation of several cases showing the influence of treatment. Dr. Walter Timme, New York.
- Polyglandular disorders with relation to epilepsy. Dr. Charles L. Dana, New York.
- Some cases of internal glandular therapy among the mentally retarded children. Dr. Mary Sutton Macy, New York
A business meeting was held in the Hotel Manhattan, in New York City on June 4, 1917, at which the permanent organization was formed. Dr. E. Eliot Harris, New York City, was elected Chairman pro tem, and Dr. George H. Hoxie, Secretary pro tem of the meeting. Dr. William Seaman Bainbridge, of New York City, spoke of the work of Dr. Eugene Hertoghe, of Antwerp, Belgium, whose work in endocrinology had done much toward furthering experimental and clinical research in this subject. Dr. Hertoghe, who was financially independent, had intended to devote both his finances and scientific ability to research in this important field when Belgium was overrun by German soldiers, which caused him to abandon his plan. Dr. Hertoghe had expressed the hope that an international association for the study of internal secretions might be formed.
Dr. Lewellys F. Barker outlined the aims and objects of the Association, saying in part: “We are hoping that the Association for the Study of Internal Secretions will bring together members of the profession who are contributing to the progress of the study of the endocrine glands, whether that study be physiological, chemical, histological, or what not. We need to have the work brought together. We hope that the bulletin of the Association, Endocrinology, will bring together all the work bearing upon the study of internal secretions. Above all, we want the clinical men to become interested. I am sure that a very important step has been taken in forming this organization. I dare say that many of us will live to be proud that we were present at this first meeting of the Association.”
Dr. C. E. deM. Sajous, of Philadelphia, called attention to the fact that relatively too much attention had been devoted to the pharmacology of the endocrine glands, which is only one phase of the subject. He especially emphasized the importance of the glands in pathology, and stated that many relationships on all sides are suggestive of the possibilities of endocrine pathology. He said this was emphasized in the nervous system, the hepatic functions, and in various other organs. Dr. Hoxie, Chairman of the Organization Committee, presented a draft of the Constitution and By-Laws which was adopted. The election resulted in the choice of the following officers and members of the Council.
Officers
- President, C. E. deM. Sajous, of Philadelphia
- Vice-President, Wm. Seaman Bainbridge, of New York
- Secretary-Treasurer, Emil Goetsch, of Baltimore
Council Members
For one year
- F. M. Pottenger, Los Angeles
- L. F. Barker, Baltimore
- Judson Daland, Philadelphia
For two years
- L. R. DeBuys, New Orleans
- Walter B. Cannon, Boston
- G. H. Hoxie, Kansas City
For three years
- John B. Potts, Omaha
- Walter Timme, New York
- R. G. Hoskins, Chicago
The first Council meeting was held on the evening of June 4, 1917, after the Annual Meeting of the Association. The following members of the Council were present: Doctors Barker, Hoxie, Pottenger, Potts, and Timme, and, ex officio, Sajous and Bainbridge.
The Council organized by electing Dr. Hoxie as Chairman, and Dr. Goetsch as Secretary.
Dr. Barker suggested that one of the important functions of the new organization was the publication of a journal. He said:
“That the time has come for the establishment of a journal devoted especially to the literature of the internal secretions can hardly be questioned by any one familiar with this literature. Despite the preoccupation of the civilized world with war, there have appeared in the past eighteen months nearly two thousand articles directly concerned with the endocrine functions. These vary in quality all the way from the most superficial to the highly abstruse. All classes, however, demand consideration. The useless articles should be cataloged and their content briefly indicated in order to save the time of busy men who might otherwise be led to consult them. To offer disparaging comment is by no means a pleasant task, but the declared purpose of the Association can not otherwise be carried out. Another class of articles is highly technical in character, of immediate interest only to the specialist. The nature of these also should be briefly indicated. A large number of the articles published, however, are of sufficient interest to endocrinologists in general to demand abstracting in greater or less detail. Finally, a considerable number of the highly technical contributions which appear in the specialized journals not accessible to many readers contain findings that should at once be made generally available. Even as an abstract journal alone, there is abundant opportunity for useful service.
It is hoped that a sufficient number of competent abstractors may be enlisted to cover completely the hundreds of medical and scientific periodicals (proceedings), and books which publish material of endocrine interest. The magnitude of this task many readers possibly do not appreciate. As an indication, however, of what a modern journal of this sort requires, it may be mentioned that the American Chemical Society is now spending some $40,000 a year on the publication of Chemical Abstracts.”
A Board of Editors was selected, consisting of C. E. deM. Sajous, of Philadelphia, and L. T. Barker, of Baltimore, for one year, and A. F. Beifeld, of Chicago, and G. H. Hoxie, of Kansas City, for two years.
The Council instructed Dr. Goetsch to enter into negotiation with Dr. R. G. Hoskins, of Chicago, with reference to assuming the editorship of the journal, and with Dr. Henry R. Harrower, with reference to assuming the responsibilities of business management.
The first number of Endocrinology appeared as of January 1917, under the Editorship of Dr. Harrower. Dr. Hoskins assumed the Editorship beginning with the July-September issue of 1917.
The Council decided that the purpose of the Association could best be carried out by incorporating, and proceeded to carry out the plan accordingly.
The Certificate of Incorporation of the Association for the Study of Internal Secretions was filed in the office of the Secretary of State of Delaware on the thirty-first day of January, 1918. The incorporators were: C. E. deM. Sajous, of Philadelphia; and L. F. Barker and Emil Goetsch, of Baltimore.
At a meeting held in Wilmington, Delaware, February 14,1918, the incorporators confirmed as Officers and Directors those who had been chosen at the New York meeting.
The first Council Meeting after incorporation took place at the home of Dr. L. F. Barker, Saturday evening, May 23, 1918, in Baltimore, Maryland.
Dr. Hoxie had resigned as Chairman of the Council, and Dr. Walter Timme was elected to fill the vacancy. Dr. Goetsch was elected Secretary.
At this meeting the resignation of Dr. Harrower as Managing Editor was received and accepted, and Dr. F. M. Pottenger, of Monrovia, California, was designated as representative of the Association on the Pacific Coast. Mr. Paul Mason was elected Assistant to Dr. Pottenger in the publicity work of the Association in the West.
The Second Annual Meeting was held at the Blackstone Hotel in Chicago, June 10, 1918, at which time four papers were discussed as follows:
- President’s Address: Comparative analysis of coordinated data in the study of internal secretions. Chas. E. deM. Sajous, Philadelphia
- The thyroid hormone and its relation to the other ductless glands. E. C. Kendall, Rochester
- A new pluriglandular syndrome. Walter Timme, New York City
- The use of adrenal products in Addison’s disease. Judson Daland, Philadelphia
The following officers were elected at this meeting:
- President, Lewellys F. Barker, Baltimore, Maryland
- First Vice-President, T. Brailsford Robertson, Berkeley, California
- Second Vice-President, H. S. Plummer, Rochester, Minnesota
- Secretary Treasurer, F. M. Pottenger, Los Angeles, California
Members of the Council for three years
- C. E. deM. Sajous, Philadelphia
- Judson Daland, Philadelphia
- F. M. Pottenger, Los Angeles
At the Third Annual Meeting, held at Atlantic City, June 9, 1919, five papers were given as follows:
- President’s Address: Remarks on the function of the suprarenal glands as revealed by clinical and pathological studies of human beings, and by experiments on animals. Lewellys F. Barker, Baltimore
- The denervated heart as an indication of adrenal secretion in pain, asphyxia and excitement. Walter B. Cannon, Boston
- Diabetes in children. Isaac A. Abt, Chicago
- Functions of the thymus gland. Edward Uhlenhuth, Rockefeller Institute, New York City
- Endocrine literature. R. G. Hoskins, Chicago
At this meeting all officers were re-elected with the exception of Dr. Robertson, First Vice-President. He was leaving for Australia, and Dr. Timme was elected in his stead.
At this meeting it was decided to change the articles of incorporation and the By-Laws to limit the powers more suitably to the needs of the Association. This was carried out during the year 1919.
These early programs show the paucity of subjects for discussion during these first meetings. It indicates how undeveloped the subject of endocrinology was at the time.
The Fourth Annual Meeting of the Association was held at the Hotel-Gruenwald, New Orleans, on Monday, April 26, 1920. The increased interest in the Association was shown by the fact that three sessions were held at this meeting and more than five hundred people attended. Furthermore, this meeting marked a turning point in the influence of the Association. During the next two decades the most conservative workers in endocrinology were to affiliate themselves with the Association and vie in securing places on the annual programs. Endocrinology was chosen as the journal in which to publish the results of their researches.
But what of the future? What further has endocrinology to offer to medicine? This can be best forecast by looking back three-quarters of a century and seeing the status of medicine at that time and following the advances which have been made. By so doing we see that endocrinology is filling one of the blank spots of the past, and is explaining many problems in development and growth, many of the secrets of metabolism, and at the same time is helping to solve some of the riddles in the realm of both emotional and physical reaction.
Scientific medicine in its early decades was dominated far more by the study of structure than function: The predominant effect of research in pathology and bacteriology was to emphasize disease and disease processes. When these subjects were at the height of their development clinical practice almost ceased to be a study of the patient. But there were men here and there who saw that no matter how great were the revelations made by the study of structure this would not solve the problems of medical practice. Such men were like voices crying in the wilderness, but they were scarcely heard.
After the beginning of the present century, however, the inadequacy of the anatomic approach began to be more fully appreciated, and at the present time it is quite fully realized that the chief interest in clinical medicine is the patient.
If the patient is to be our first interest, it is necessary to understand him as a complete functioning unit. We must seek to understand all mechanisms which are responsible for normal activity; for these are the same that show reaction in case of abnormal stimulation. Symptoms may be primarily due to disturbances in any single physiologic system–the endocrine, the nervous, or the electrolytic–but these are so intimately bound together that a disturbance in one is reflected in the others. The study of medicine then becomes a study of the disturbances in function which are produced by any and all morbific agents in any and all physiologic systems of the body. The proof of this fact is one of the contributions that the study of endocrinology is making to medicine, and the further elaboration of it is one of its greatest possibilities for the future.
The development of this physiologic phase of medicine is necessarily slower than that in which changes in structure could be followed by the microscope, because we are studying living, functioning processes in human beings who are subject to the effects of all the physical forces with which they come in contact, and all the emotional stresses which may affect them as individuals.
The early era in the development of physiology was confined largely to the study of the voluntary nervous system, and to the simpler disturbances in digestion, respiration, circulation, and the genito-urinary system. But these studies are relatively simple as compared with the complex physiologic problems. which still remain to be investigated, such as those connected with the direct action and the correlating action of the products of the endocrine glands, the visceral nerves, the enzymes, and the electrolytes.
To make the subject more complex it must be borne in mind that higher mechanisms are made up of individual cells and as pathologic anatomy expresses itself in the cell so does pathologic physiology. How each cell can live and maintain its individuality in a complex organism and take from the humoral tissues which bathe it the substances which are suited to its existence and function and reject others is a matter of great importance and one of greatest wonder.
As endocrinology develops it reveals its intimate relationship to all physiologic systems of the body. It shows that our knowledge cannot be rounded out by developing from a standpoint of an individual system. While it may be necessary for us to conduct our research from the standpoint of endocrinology, the visceral nerves, the electrolytes or the enzymes, this will not satisfy the facts of physiology, for all physiologic systems dovetail intimately into each other. And while we are finding that the dominant activity of certain glands may seem to be expressed in some special organ or some special function, there are wider activities which express themselves throughout the entire body that are of equal and in some instances probably of greater importance. Endocrinologic practice, therefore, does not belong to any particular specialty, but has a wide application to every phase of medicine.
Scientific medicine has awaited with impatience the development of endocrinology. It must await further the study of the visceral nerves, the enzymes, and the electrolytes and their integrating functions. Then and then only can we understand the individual from the time of conception through the various periods of growth, development, and activity through life. Endocrinology requires intensive laboratory research, but its final measure will be determined by its application to the benefit of the human race. A hormone may be ineffective by itself, but if study can reveal the entire physiologic mechanisms upon which it acts and upon which it depends for completion of its action, then it can be made of greatest importance to mankind.