The Endocrinology of Tuberculosis

It is suggested that the endocrines hold the key position in the mechanism of resistance to all infection. In man the glands of internal secretion are divided into two counterbalancing groups. It is the function of the "katabolic" group-or glands of emergency-to react to acute infections. It is the function of the "anabolic" group-or glands of conservation of energy-to counterbalance the prolonged over-action of the katabolic group in chronic infections. In chronic pulmonary tuberculosis improvement is dependent on the predominance of the anabolic group. Clinical and biochemical evidence to this effect is brought forward. The individual ductless glands are discussed with a view to summarizing the known tests for detecting their functional variations during life. It is suggested that present methods for the determination of basal metabolic rate are inaccurate and cumbersome. An alternative biochemical method is described and illustrated, which, it is claimed, is both more simple and more accurate. Slides of the thyroid and parathyroid are shown indicating that the histological criteria of function correlate with these biochemical findings during life. The classification of cases of pulmonary tuberculosis according to the mode of reaction rather than to the extent of lung invasion, is advocated. A terminology and the clinical, endocrine, and applied biochemical tests by which the groups can be recognized are described.Emphasis is laid on the necessity for research into the hereditary and environmental factors which lead to injury of the ductless glands, and hence lowered resistance to disease.