The findings after death confirm the view of him as an unstable pituitocentric who succumbed to pituitary insufficiency toward the latter half of his life. We possess the account of the postmortem by Dr. Henry, who performed it. "The whole surface of the body was deeply covered with fat. Over the sternum, where generally the bone is very superficial, the fat was upwards of an inch deep, and an inch and a half or two inches on the abdomen. There was scarcely any hair on the body, and that of the head was thin, fine and silky. The whole genital system (very small) seemed to exhibit a physical cause for the absence of sexual desire, and the chastity which had been stated to have characterized the deceased (during his stay at St. Helena). The skin was noticed to be very white and delicate as were the hands and arms. Indeed the whole body was slender and effeminate. The pubis much resembled the Mons Veneris in women. The muscles of the chest were small, the shoulders were narrow and the hips wide." In other words, the typical feminization of the body which accompanies pituitary insufficiency was found. He died of a cancer of the stomach. But before his death there were noted the mental transformations that succeed deficiency of his central endocrine. Apathy, indolence, fatigability, and frilosity were what impressed his associates at St. Helena. The deterioration of his mentality was also exemplified in his literary diversions, the "Siege of Troy" and the "Essay on Suicide." The puerility of these productions, as well as of his conduct, a sulking before his captors, and the decline of his physical energy, once a bottomless well, all point to the same conclusion.

The rise and fall of Napoleon followed the rise and fall of his pituitary gland. No better illustration exists of the fundamental determination of a personality and its career by an endocrine, aside from other factors of education, environment, accident and opportunity. Without the sort of endocrine equipment he was born with, however, none of the other factors would have found the material to work upon. Born, say, with more of a posterior pituitary than he had, which would have rendered him more sensitive to the sufferings of his fellow-creatures, if nothing else, and the forces of the Revolution probably would have swamped him from the very first moment of his emergence at Toulon, when the whiff of grape-shot, symptom of an inexorable, merciless intellect and will, started him upon the road that led to the Napoleonic Era. Destiny is always ironic. For the deficiency of the internal secretions which made him eligible for glory was responsible as well as for his downfall.

EPILEPSY AND MIGRAINE IN GENIUS

In the annals of genius, there occur a number of instances of those who suffered from attacks that have been diagnosed epilepsy or migraine. Because their ailment was associated with their extraordinary ability, they attracted an attention that concerned itself not at all with the circumstance that genius has also been liable to measles, scarlet fever, and so on. Epilepsy and migraine certainly occur in people of no supernormal gifts, and often in degenerates and subnormals. Yet the fact remains that these affections of the nervous system, so terrible to feel and to behold, have afflicted the finest brains of the race.

About forty years ago the idea established itself that epilepsy, exhibiting itself in one form or another as "fits," and migraine, the severe periodic sick headache, were interconvertible manifestations of the same underlying morbid process in the brain. Nothing in the way of a concrete cause, attackable on the material side, was elicited by this generalization. Then the investigations of the pituitary in the last decade produced evidence of epilepsy-like and migraine-like symptoms in sufferers from tumors or other enlargements of it. Reasoning back, cases of epilepsy and migraine began to be examined for evidences of involvement of the pituitary in their troubles. These accumulated rapidly. The physiognomy and physique of the pituito-centric were discovered in them. The phenomena noted in Napoleon's case were often present: lowering of the pulse, chilliness, and an increased irritability of the bladder. In women the attack often coincides with the menstrual period, a typical time of endocrine unbalance. Finally X-ray examinations of the sella turcica, the bony lodging of the pituitary, clinched the matter: it often appeared small, or enlarged, with erosions of the bone, signifying a desperate attempt of the gland to grow, and meet the needs of the organism. The complex of appearances called migraine now becomes understandable. There are a number of factors, such as fatigue, intense cold, or high sugar food like chocolate, which will cause an engorgement of the gland with blood and swelling of it. But they do not concern us now. Intense mental occupation, concentration as the popular term has it, acts as a patent excitor of the attack.

Brain work drives more blood into the brain and the gland. Besides, mental activity is accompanied by increased function of the ante-pituitary, if intellectual, or of the post-pituitary if emotional. Brain work then causes a temporary enlargement of the gland. If, now, the bone container of the endocrine is too small to permit of much swelling, the bone will be pressed against or even worn into. This means headache, severe, easily going on to the kind known as sick-headache. The nerves which move the eyes in various directions lie next to the pituitary. If, in its expansion, it moves sufficiently outward, it may press upon, irritate them or paralyze, and so evolve various eye disturbances in association with the headache. No one can overrate this conception of migraine, for a number of men of genius have suffered from sick-headache and eye symptoms.

As for epilepsy, the problem is more complex. One has to rule out first those who have organic destructive disease of the brain. But they are out of our field: genius predicates at least an intact brain. Of the others a number may be interpreted upon an endocrine basis. At least they will, in their physiognomy, physique, mentality, conduct and character, document the glandular constellation under which they live, and a proper understanding of which is necessary for them to be helped. One frequently seen is the thymo-centric, with small enclosed sella turcica. The latter fact explains the occurrence of the epilepsy. Periodic variations in the secretory tides of the other endocrines, the ovaries, the thyroid, and so on, may determine the onset of the attack of "fits." The point is that when epilepsy plays a constant part in the life history of a man of genius, we are justified in assuming a disturbed balance among his hormones, and so a reasoned picture perhaps of the foundations for the erratic in his behaviour or his productions.

THE NEURASTHENIC GENIUS

The fin de siecle intelligentsia of the nineteenth century were quite stirred up by a publication of Max Nordau on "Degeneration," in which a number of revered artists and intelligents were held up to public scorn as degenerates and neurasthenics. So wrought up were they, in fact, that Bernard Shaw was moved to compose a defense entitled "The Sanity of Art." In spite of the Great Vegetarian's dialectics, it remains to be explained why a certain species of creative ability has been combined with the fatigability, variability and general wretched irritability of every organ and tissue in the body which taught them that they were sensitive souls imprisoned in the flesh. Going from doctor to doctor as from pillar to post, from this medical creed to that hygienic cult, lucky to escape the worst, often landing upon the bosom of New Thought for succor. We have noted in previous chapters the relation of neurasthenia to the glands of internal secretion in general, and to adrenal insufficiency in particular. A closer examination of neurasthenic genius will show it to consist essentially of a pituitocentric in whom for one reason or another, congenital (the persistence of the thymus) or acquired (shocks, accidents, diseases) there has been failure of the adrenals, thyroid or the interstitial cells, about in the order of their occurrence.

THE CASE OF NIETZSCHE

Friedrich Nietzsche is about as good a case as there is on record of a genius blasted by migraine. The originality and force of his mind, as well as the articulate music of an imaginative poet, places Nietzsche among the philosophic elect of the race. Showing that he was an unstable pituitary-centered of a certain type will throw light upon his malady, as well as upon his life and work.

In a set of volumes, entitled Biographic Clinics, Dr. George M. Gould of Philadelphia contended that the ill health of a number of men and women of genius of the nineteenth century was due to unconnected eye troubles. In attempting to bolster up his thesis he has collected biographic material useful to the student of personality. He never appears to have asked himself what was behind the eye trouble. The evidence relating to Nietzsche's endocrine personality is derived from some of the data he collected, as well as from the two volume life of the philosopher written by his sister, and the other biographies of him extant.

To reconstruct the endocrine formula or equation of Nietzsche inductively, one should analyze first the information available concerning his parents and relatives. His grandfather was a conservative bourgeois of a superior type, who was the author of treatises designed to narcotize the forces of rebellion of his time. What he was like physically, no epitaph declares. His father was a clergyman. A description of him reads ... "tall and slender, with a noble and poetic personality, and a peculiar talent for music ... short-sighted." That ranks him at once as a pituito-centric. The mother was dark and had a fiery temper and came of a family distinguished for the powerfully built anatomy of its members. In the heredity of Nietzsche, the father appears therefore to supply a pituitary predominating element, the mother an adrenal-pituitary predominating element.

Nietzsche himself worked strenuously at the intellectual life (after 20, when he probably stopped growing, and the brain tonic action of the ante-pituitary could manifest itself). Early distinction rewarded him with a professorship in philology at 24. One of Prussia's wars of conquest entangled him, and presented him with diphtheria. A friendship with Richard Wagner marked the turning point of his life, and the point of departure for his works on the most fundamental values of human life. Meanwhile, attacks of sick-headache of varying degrees of severity made him miserable periodically—they came about every two weeks and lasted two to three days—and left him wretched and exhausted. At last, at 44, a species of stroke terminated his sufferings, causing him to lose his speech and memory, and thenceforth there was progressive deterioration, physical and spiritual, with repeated attacks.

In the sister's biography there are several good photographs and reproductions of sculptures of Nietzsche at different ages. An examination of the frontispiece picture, which shows him in profile (profile views are the best for physiognomy), as well as of the bust of Nietzsche by Donndorf, exhibit the most striking traits of the head. To the student of internal secretions, the most prominent feature of the face, emphasized by both the camera and the artist, is the remarkable prominence of the supra-orbital arches, the bony protuberances from which the eyebrows spring. This is a definite pituitary character. The eyebrows themselves are luxurious and slope to meet, the bony development of the face as a whole is sharp and clean-cut, the skull tends to be long and narrow and the chin is square. All these point to a pituitary-centered personality. It is to be regretted that we have no picture or record of Nietzsche caught smiling, which would have preserved the state of his teeth for us. At any rate, considered as checks to my interpretation, his physiognomy and physique, the nature of his genius and the attacks which finally ruined his life, all fit into the conception of him as one whose life centered, like Napoleon's, around what was happening in his sella turcica.

The attacks of sick-headache, diagnosable symptomatically as migraine, were so devastating that in 1883, after the printing of his masterpiece, "Also Sprach Zarathustra," he wrote "My life has been a complete failure." Extracts from his letters, collected by Gould, provide some idea of his suffering. In 1888, just before his stroke, he said, "I have in my eyes a dynamometer of my entire condition."

The history of Nietzsche's eye trouble makes it probable that not simply a defect in his eyes themselves, but a deeper condition behind them was responsible. Up to the age of 15 he was a model scholar. Essential eye defects of refraction should make themselves felt during childhood. Then, with adolescence, he changed. Adolescence is one of the red-letter epochs for the pituitary, when its growth and enlargement precedes and stimulates the ripening of the sex cells in the reproductive organs. Until adolescence ended and physical development ceased, his intellectual interests were nil, and he was particularly backward in mathematics. Colds and coughs, and recurring pains in the head and eyes bothered him (colds and coughs are frequent in those whose pituitary expansion is limited by the bony sella turcica to any extent). After his puberty, migraine definitely became his demon companion. Following the diphtheria in the army (which must have damaged his adrenals), the attacks grew much worse, and complaints about them more bitter because the pituitary now, in addition to its own burden, had to compensate for the insufficient adrenals. So "his frequent illness made him more and more a subject of treatment and commiseration.... If only my eyes would hold out ... it seems to me at the age of 30 as if I had lived 60 years ... very frequent sufferings of stomach, head and eyes ... acidity oppresses me, and everything except the tenderest food becomes acid.... I cannot doubt that I am the victim of a serious cerebral disease, and that stomach and eyes suffer only from this central cause ... half-dead with pain and exhaustion." In December 1888, he fell, had to be helped home, lay silent for two days, then became loud, active and unbalanced. The attack was preceded by the drinking of much water.

The specific quality of the Nietzsche genius also directs attention to a pituitocentric, to a pituitocentric in whom both ante-pituitary and post-pituitary are extraordinarily well-functioning, but are in a state of unbalance in which the post-pituitary gets the upper hand. Now, as we have seen, the post-pituitary makes for that instability of association between the brain cells which must be at the bottom of originality and creative thought, as well as of phobias, obsessions, hysterias and hallucinations. Persons in whom the post-pituitary predominates have a lively fancy and are liable to suffer from the tricks of association. Nietzsche, as we have noted, was poor in mathematics and in the calm cool proportioned forward march of scientific thought in general. His most brilliant ideas came to him in flashes and gleams. That is why so much of his work has come down to us in the form of aphorisms and paragraphs. He was, essentially, a poet among the metaphysicians, which again favors the conception of him as a pituitary-centered with a dominant post-pituitary. Yet his incisive critical faculty, as well as his love of music, also document the supernormal ante-pituitary.

To sum up, the physique and physiognomy of Nietzsche, his migraine attacks and the later fate which overtook him, his likes and dislikes, his tastes, abilities and accomplishments followed from his composition as one pituitary-centered, with post-pituitary domination, a superior thyroid, and inferior adrenals.

DARWIN AS A NEURASTHENIC GENIUS

Charles Darwin, as the author of the "Origin of Species" and the greatest revolutionist of the nineteenth century, has naturally had a great deal of attention paid to his life and personality. Yet not until the publication of his Autobiography and his son's Reminiscences was it generally known that he suffered from chronic ill health for most of his adult life. Dr. W.A. Johnston, in an article in the American Anthropologist, 1901, has marshalled a number of available facts, to sustain his thesis that Darwin was a victim of neurasthenia. Now neurasthenia, it is now accepted, is simply a waste-basket word, corresponding to the class miscellaneous in a classification of any group of real objects. And, as has been emphasized in preceding chapters, most neurasthenia rises upon a disturbed endocrine foundation, most often, an insufficiency of the adrenals. That is, a defect in the chain of co-operation, balance and compensation among the internal secretions is the basis for the weakness of the nervous system the term neurasthenia is supposed to explain, actually only names. Darwin's case was pretty certainly that.

There can be no doubt that Darwin had an abnormal fatigability, a lack of stamina and endurance in mental as well as physical application which plagued him from the late twenties to the sixties. As a child, he was strong and healthy, fond of outdoors, and though underrated by his teachers, noted to be possessed of intense curiosity, especially concerning natural objects. At school he was a fleet runner and cultivated a habit of long walks. Then he was surely no neurasthenic. Three years which, he himself afterwards said, were worse than wasted, at Cambridge, were filled with shooting, riding and hunting. His good health lasted until the time he probably stopped growing at 21 or 22. Thereafter his troubles began.

What was Darwin, so far as his endocrine composition was concerned? In the first place his father was a variety of pituitocentric, of the post-pituitary inferior type, six feet two inches tall, exceedingly corpulent, and, in the eyes of his son, the sharpest of observers and the most sympathetic of men. He wished to make a physician out of his son in order to carry on the medical tradition of the family: Erasmus Darwin was a physician before him. His son, however, showed no inclination for so learned and confining a profession and had to be reproached by his father in these immortal words: "You care for nothing but shooting dogs, and rat-catching, and you will be a disgrace to yourself and all your family."

Cambridge came after Edinburgh, as he was rushed from medicine into the clergy. But in vain. A friendship struck up with a naturalist, Henslow, settled his career for him. Henslow heard of a trip of general exploration the ship Beagle was to take and recommended Darwin as naturalist. The captain at first would not hear of the proposal because of Darwin's nose, a typical pituitary proboscis. But his prejudices were overcome, and Darwin sailed.

It was upon this voyage that Darwin made himself the greatest naturalist of all time, and at the same time infected himself with the virus of neurasthenia. At Plymouth, while waiting for the ship to sail, he complained of palpitation and pain about the heart, probably due to a transient hyperthyroidism, brought on by excitement. During the voyage, which lasted five years, he was afflicted often by sea-sickness. A ship-mate relates that after spending an hour with the microscope he would say "Old Fellow, I must take the horizontal for it" and lie down. He would stretch out on one side of the table, then resume his labors for a while when he again had to lie down. Already fatigability had to be fed with rest. A serious illness that Darwin claimed affected every secretion of his body acted probably as the exhausting drain upon his adrenal potential.

The return to England was the date of onset for a record of continuous illness, aggravated by his marriage, apparently, for his misery increased progressively after it. So much so that he was forced to leave London altogether so as to avoid the strain of social life, even that of meeting his scientific friends or attending scientific society meetings fatiguing him to exhaustion. After such occasions there would be attacks of violent shivering, with vomiting and giddiness. It was necessary for him to impose upon himself an absolute regime of daily routine. Any interference with it upset him completely, and made it impossible for him to do any work. Early morning was the only time for physical as we; as mental exertion. Evening found him thoroughly used up, with every move an effort. Insomnia made him its prey. A curious sensitiveness to heat and cold distressed him. In 1859, when the "Origin of Species" appeared, he wrote to a friend that his health had quite failed, and that indigestion, headaches, with a looming hopeless breakdown of body and mind made his life a burden and a curse. The twenty years of research he devoted to the problems of evolution were one long torture. For sixteen more years, during which he worked upon and produced immortal classics of biology, he was the most wretched and unhappy sufferer from neurasthenia. His life was a continuous alternation of small doses of work and large doses of rest. So he was enabled to publish twenty-three volumes of original writing and fifty-one scientific papers. Living a sort of quasi-sanitarium life, with the rules and regulations of one undergoing a rest cure for thirty-six years, he thus accomplished infinitely more than the millions who have led the strenuous life. That he thus survived, as a genius, among the perils of an intellectual nature in an environment for which his adrenals sentenced him to destruction, must be put down in large measure to the ministrations and good sense of wife and children who supplied him with the endocrine energy he lacked. All these details I have given in the attempt to analyze the internal secretion constitution of this great man of genius, to establish that he really suffered from inadequate function of his adrenal glands, for the symptoms of chronic though benign adrenal insufficiency coincide in their mass effect with the story of his life. He was not a good animal, as Herbert Spencer declared was a first sine qua non of the successful life. He was a poor animal, the poorest of animals, because he possessed poor adrenals. What saved him was his congenitally superior pituitary (the nidus of genius) and the overacting thyroid, which combined to compensate to some extent for his fundamental lack. According to his son he rose early because he could not lie in bed, and he would have liked to get up earlier than he did.

What other hints have we that in spite of his fatigue disease he was a pituitocentric? The record of his physique and physiognomy, documentary and that left in portraits and photographs. He was tall and thin and his frame was naturally strong and large. Face was ruddy, and his grey eyes looked out from under deep overhanging brows and bushy eyebrows. The ears were large and prominent, the hair straight, the nose broad and well developed. All these are distinctive pituitary traits. The photograph of him taken by Maull and Fox in 1854 shows his chin to be the square firm kind that goes with the ante-pituitary type physique. (This photo is the frontispiece of the collection of essays entitled "Darwinism and Modern Science," edited by A.C. Seward and published in 1909). Charles Darwin, we may say, then, lived the life of one with a hyperfunctioning pituitary, the anterior portion dominating the posterior, a thyroid excess, and an adrenal much deficient, the combination settling the fate of a grand intellect in an invalid. It is interesting to note that an extant portrait of Erasmus Darwin, Darwin's distinguished grandfather, shows a pituitocentric, but with a rounder head and a fatter face, which point to a predominance of the post-pituitary over the ante-pituitary. Correspondingly, he was more speculative and poetic intellectually than his grandson, and more irascible and imperious in his moods.

After 1872, when Charles Darwin was sixty-three years old, a marked change for the better occurred in his health. For the last ten years of his life the condition of his health was a cause of satisfaction and hope to his family. "He was able to work more steadily with less fatigue and distress afterwards." This is probably to be explained as following the gonadopause hi him—the cessation of activity of the interstitial cells. After this event, the adrenals in the male nearly always function more efficiently, and well being is improved even though the blood pressure often rises coincidently. In the relative vigor of that decade we have another bit of evidence that the adrenals had much to say over Darwin's life.

EPILEPTIC GENIUS

He had a fever when he was in Spain And, when the fit was on him, I did mark How he did shake: 'tis true, this god did shake His coward lips did from their color fly; And that same eye whose bend doth awe the world, Did lose his lustre: I did hear him groan.

—Julius Caesar.

Epilepsy, the "falling sickness" or "fits," is generally associated with a deterioration or degeneration of mentality, and an inferior personality is frequently an ingredient. Progressively increasing data accumulate to incriminate more and more a disturbance of the endocrine balance, on the side of multiple deficiencies, as the basic mechanism at the bottom of a good many of them. Concurrent studies reveal that abnormalities of the thyroid, the parathyroids, the ovaries and testes, and even the thymus exist behind the attack. Investigation of the content of the consciousness of the different kinds of epilepsies from this point of view will doubtless bring to light some interesting information. There is much to be done for the epileptic with this new method of approach.

Epilepsy, just the same, may occur in men gifted with the sort of transcendent ability called genius. Mohammed, Lord Byron, Dostoyevsky, Flaubert, to name a few cases, are famous instances. The point to be settled is whether epileptic genius, that is epilepsy with superior ability, occurs most often in pituitocentrics, the epilepsy being symptomatic of a pituitary struggling against barriers, tugging against bonds. As mentioned, in such cases epilepsy appears as the twin brother of migraine in genius. Should that be established, we should have more evidence for the pituitary dominance of most specimens of intellectual power. As a case in point let us take the most famous of the epileptic geniuses—Julius Caesar, "When the fit was on I marked how he did shake; tis true, this god did shake."

According to Plutarch, Julius Caesar was of slender build, fair-complexioned, pale, emaciated, of a delicate constitution (reminding us of Darwin), subject to severe headache and violent attacks of epilepsy. In view of the work of Cushing, the concurrence of "severe headache and violent attacks of epilepsy" is sharply suggestive of a pituitary origin for both. In his seventeenth year he was already engaged to be married, which proves his precocity. An overactive, erratic pituitary could here also be held responsible. Soon after he was proscribed by the dictator Sulla, and the first of a series of epileptic convulsions is recorded. Shock tries the pituitary, as well as the adrenals.

His sexual libido was of the quality that stimulated his soldiers to sing celebrations of his exploits. The first woman he was engaged to be jilted. Cornelia, his first wife, he divorced on the ground that "Caesar's wife must be above suspicion." Matrimony committed twice thereafter landing him in the divorce court, he devoted himself to liaisons, one with Cleopatra. This sexual hyperactivity was probably another pituitary trait.

The compound of intellectual and practical ability he realized was of the rarest. It meant a most delicate balance between his ante-pituitary, post-pituitary, adrenals and thyroid. He was an orator, politician, historian, conqueror, and statesman. That his thyroid functioned well can be deduced from a career which involved more than three hundred personal triumphs as recognition from his native city. On horseback, riding without using his hands, he would often dictate to two or three secretaries at once. The masculine love of glory and ambition, expression of a well-working ante-pituitary, was combined with the effeminate echoes of an equally well-evolved post-pituitary. No prima donna was more concerned with the care of her skin, complexion and hair than he. The analogy extends even to superfluous hair which he had removed, not by the modern electrolysis, but by depilation with forceps and main force. The attendants at his bath would polish his epidermis, for his satisfaction, until it resembled alabaster or marble.

Caesar was not the kind of great man that Darwin was, and only a rather muddled careerist because he had too much adrenal and post-pituitary. But he was pituitocentric of a certain type. We possess no authentic portraits or busts of him to go by. But the bust in the Museum of Naples, for which he probably sat (some, H.G. Wells among them, will not accept this), presents the sort of face that is often seen in pituitary epileptics, and the features and skull of a pituitocentric: long, large, well-modeled head eyebrows prominent, with tendency to meet, aquiline nose and strong chin.

In these three, Napoleon, Nietzsche and Caesar, we have male pituitocentrics, exhibiting diversities of life and tastes because of differences in the co-working endocrine glands in their makeup. We shall consider now a female pituitocentric who presents the strangest contrasts in physique, physiognomy, conduct and character, dependent upon a variation in the balance between the two portions of the pituitary.

THE LEGEND OF FLORENCE NIGHTINGALE

All biographies consist of prevarications and all autobiographies of fiction. That summing up of a mass of literature over which industrious students have ruined their eyes, held good until after the War, when things changed. Then Mr. Lytton Strachey, at one fell blow, and with one magnificent masterpiece, hurdled the old idols and established a new standard of deliberate accuracy in print. In his "Eminent Victorians" he set the pace for the host of those who have been stimulated by his good example, like Lady Margot Asquith.

Of the four Victorian respectable worthies Strachey has dissected as ruthlessly as the anatomist a post-mortem, his portrait of Florence Nightingale, the founder of the modern science and art of nursing, is most interesting because it provides data of the utmost value to the student of the endocrine basis of human personality. In the conventional two-volume biography of this superwoman, she is pictured as an intellectual saint, stepped from a stained glass window upon her wonderful visit to a clay-smeared earth. The biographer, presenting all the ins and outs of her body and soul as he has, makes her live before us with a fresh vitality that is startling.

The species of life Florence Nightingale lived, involving as it did struggle with a masculine world, and conquest of it, implies the existence in her of certain masculine traits and marks, for the normal feminine psyche is submissive rather than aggressive toward its environment, human and otherwise. Belonging to a family in the highest circles, it was upon the table d'hote of her destiny that she should become a regulation debutante, careeristina, and successful wife and mother. Instead, she chose to question the whole routine of the life of her class, and in her diary she records her doubts and cravings, and her revolt against what is assumed by her family and friends to be the normal course of existence for her. The attitudes and questionings in these passages, the religious feeling displayed, are distinctly masculine. Most easily could the following, for instance, pass as having been written by a man: "I desire for a considerable time only to lead a life of obscurity and toil, for the purpose of allowing whatever I may have received of God to ripen, and turning it some day to the glory of His Name. Nowadays people are too much in a hurry both to produce and consume themselves. It is only in retirement, in silence, in meditation that are formed the men who are called to exercise an influence upon society." In a note-book she puts May 7, 1852, as the date upon which she was conscious of a call from God to be a saviour. Now the vast majority of women who have remained spinsters at 32, in spite of considerable personal attractions and high natural ability, are visited by waves of emotional fervor for a de-personalization of the self. But in the case of the subject, as Strachey has so well shown, the call was pursued with a self-willed, pitiless, unscrupulous determination, worthy of Satan himself upon the most ferocious evil bent. In its pursuit indeed she became what her latest biographer has called a "woman possessed by a Demon." All necessary, not alone because if she had been meek and mild she would have existed in futility, but because of the high percentage of the masculine endocrines in her composition. It is most regrettable that we have no statement of the findings of a gynecologic examination of her. That she was almost consciously masculine may be inferred not only from the way she bullied Lord Pannure and worked to death her dearest friend with the angelic temper, Sidney Herbert, who was so amiable that he could be driven by one who wrote: "I have done with being amiable. It is the mother of all mischief." She could also write, "I attribute my success to this: I never gave or took an excuse. Yes, I do see the difference now between me and other men. When a disaster happens, I act, and they make excuses."

Lytton Strachey has painted superbly all this in his essay. But for us his most significant passage is the following: "When old age actually came, something curious happened. Destiny, having waited patiently, played a queer trick upon Miss Nightingale. The benevolence and public spirit of that long life had only been equaled by its acerbity. Her virtue had dwelt in hardness, and she had poured forth her unstinted usefulness with a bitter smile upon her lips. And now the sacredness of years brought the proud woman her punishment. She was not to die as she had lived. The sting was to be taken out of her: she was to be made soft; she was to be reduced to compliance and complacency. The change came gradually, but at last it was unmistakable."

"There appeared a corresponding alteration in her physical mould. The thin, angular woman, with her haughty eye, and her acrid mouth, had vanished, and in her place was the rounded, bulky form of a fat old lady, smiling all day long. Then something else became visible. The brain which had been steeled at Scutari was, indeed, literally growing soft. Senility—an ever more and more amiable senility—descended."

We have here an absolutely typical pituitary history, with another case of pituitocentric natural ability. What happens when pituitary hyperfunction or superiority becomes underfunction or inferiority is precisely as Strachey has described so cleverly of the "ministering angel": the acrid, thin and keen degenerate every time into the amiable, fat and dull. Just as Napoleon was transformed by the mutations of his pituitary, so was the Saint with the Lamp. And in both instances the contrasting modifications, from one extreme of glandular function to the other, supply us with the clue to the secret hand of their inner being and becoming, which worked upon the twists and turns of circumstance about them as a sculptor upon clay.

The official biography by Sir Edward Cook contains three portraits, representing three different stages, which bear out the pituitocentric thesis of her personality and life history. One as she was at 25, and pictured by Mrs. Gaskell: "She is tall; very straight and willowy in figure; thick and shortish rich brown hair; very delicate complexion ... perfect teeth ... perfect grace and lovely appearance ... she is so like a saint." The face is long and oval, of the post-pituitary kind. Then gradually the ante-pituitary gained an ascendency in the concert of her internal secretions, so coloring her life with its masculine tints, and altering her face as well as her disposition. The photograph of her taken when she was 38 shows a quadrangular outline, and all the acridity that impressed Strachey. The last picture of her, a water color drawing made in 1907, shows a round visaged old dame, who might be the peasant grandmother of two dozen descendants. Little patches of red over the cheek bones remind one of myxedema and indicate that toward the very end of her life her thyroid failed her as well as her pituitary. So that our biographer relates: "Then by Royal Command, the Order of Merit was brought to South Street, and there was a little ceremony of presentation. Sir Douglas Dawson, after a short speech, stepped forward and handed the order of the insignia to Miss Nightingale. Propped up by pillows, she dimly recognized that some compliment was being paid her. 'Too kind—too kind!' she murmured; and she was not ironical." In the days of pituitary and thyroid hyperfunction we may be sure she would have been caustically and penetratingly ironical.

THE EXPLANATION OF OSCAR WILDE

The case of Oscar Wilde, as one of the high tragedies of English Literature and Life, attracted the attention of the whole world in its heyday, and even today evokes controversy. As a literary figure and artist, the poet of the Portrait of Dorian Gray, and "De Profundis," belongs without a doubt to the immortals. As a convicted criminal, who served for two years at hard labor in Reading jail, and afterwards, a prey to chronic alcoholism, died in obscurity in Paris, he still remains a subject of whispered conversation in private, and his crime a taboo to the public, mentionable only at the risk of arousing the terrible odium sexicum of the prurient majority. Oscar Wilde was a homosexual of a certain type. In view of the previously laid down considerations concerning the endocrine genesis of homosexuality, how are we to explain him, and his natural history?

As with the other exemplars of genius examined we need here, too, to gain some insight into his "internal secretion heredity." His father, Sir William Wilde, was a surgeon. Photographs of him show the long and broad face of a pituito-adrenal centered individual, with a corresponding duplex incarnation in the face, the upper half strikingly spiritual, the lower curiously animal.

He was active, practical and eminently successful. His wife recalls Florence Nightingale, in face, figure and conduct (people who are built alike as regards their internal secretions are those whom we recognize as similar physically and psychically). She, too, was a pituito-adrenal, and in so far resembled her husband. But as in a woman ante-pituitary and adrenal superiority make for masculinity, she must be classed as a masculinoid type of woman. She was socially aggressive, and took part in the revolutionary movement of her time in Ireland. Thus we find that Oscar Wilde was the result of a mating of internal secretions acting in the same direction. The process might be compared to parthenogenesis.

It is on record that when enceinte his mother often expressed the wish that her child be a girl. When a boy was born, she was immensely disappointed. To compensate for her disappointment, she brought him up a good deal like a little girl. She had him dressed in girls' clothes at an age when most boys are violent destroyers of clothing. She would hang massive jewelry upon him, for the delight of playing with the resultant stage picture as a satisfaction for her discontented desires. In the light of modern psychology, and our formulization of her endocrine status, we must put down her conduct to a suppressed homosexual craving. Had her son been built along the lines of strong emphatic masculinity, her influence, though vicious, would probably have found no congenial soil, and would have died out altogether after his contacts with the outer world, beginning with school. No matter how she would have conditioned his vegetative system temporarily, his internal secretions, released then from compression, would have asserted themselves and determined his fate differently. However, it is quite possible that if such had been the case Oscar Wilde, the aesthete, the paradoxer, the disciple of Walter Pater and Baudelaire, would have stayed in the land of the to be born. I mean that then we would not have had Oscar Wilde, but another person, genius or commonplace, who also might have borne the name of Oscar Wilde.

That was not to be. The singular assortment of endocrines that mingled their activities to make Oscar Wilde shaped a personality which we must classify as the thymocentric (thymus-centered). Why this should be so is an interesting question. Pituito-adrenal plus pituito-adrenal of his heredity should make two pituito-adrenals according to elementary arithmetic and the rule of three. A cancellation of the two factors of the equation rather than addition seems to have occurred. The result was a persistent thymus superiority, with an instability of the other two main glands involved.

How do we know that Oscar Wilde was a thymocentric? Because in his fullest development he exhibited all the earmarks of the thymus pattern. We possess a number of good pictures and descriptions of him, as he was really a contemporary, and would probably be alive today if he had been put in a hospital for proper treatment instead of in prison. An excellent description is that of Henri de Regnier's: "This foreigner (Wilde) was tall, and of great corpulence. A high complexion seemed to give still greater width to his clean shaven face. It was the unbearded (glabre) face that one sees on coins. The hands ... were rather fleshy and plump." The points of immediate interest are the height, the complexion and the beardlessness. One classic variety of the thymocentric is tall, has a baby's skin, and has little or no hair on the face. A passage from a narrative written by one of his warders confirms the last condition decidedly. "Before leaving his cell to see a visitor, he was alway careful to conceal, as far as possible, his unshaven chin by means of his red handkerchief." Bristles on the chin, with little or none on the cheeks, is the inference. It is important to stress the thymocentric significance of this glabrosity of the face. Another sign to be put in italics was the quality of his voice. It has been described as a beautiful tenor, when he had it under perfect control, and high pitched and strident when under the influence of passion or temper. Such a voice would be the product of a larynx remaining partly or completely in the infantile state, as in a woman's. That, and the large breasts he is said to have had, point again to the thymus-centered constitution. All in all, there can be no doubt that Oscar Wilde was a case of status lymphaticus, the technical name for the thymus-centered personality.

As happens in a number of thymocentrics, his pituitary must have attempted to compensate for the endocrine deficiencies always present in them. The exceptional size of his head was a pituitary trait. Finding, possibly making, plenty of room for itself to grow, for some unknown reason, in an extraordinary fashion, it reinforced the love of the beautiful that is part of the feminine post-pituitary nature, with an intellectual ability and maturity that was at first all-conquering. In the face of a society organized for pure masculine and pure feminine types, disgrace and disaster at last overtook him with almost the ruthlessness of natural selection wiping out an unadapted sport suddenly cropping up in an environment. In prison he suffered from severe splitting headaches, which were probably due to changes in his pituitary. Described as being directly over the eyes, they haunted him until his death, and may have had a good deal to do with the absinthe addiction he acquired.

THE TREATMENT OF GENIUS

The problem of Oscar Wilde raises an ethical question that still remains to be finally answered. Granting that all of society should one day see him and his kind as a peculiar and specific constitutional product of an odd intermixture of internal secretions, what should be done with him and them? It is easy to play with words like "degenerates." But still, we do not condemn imbeciles, idiots or defectives, or other substandard, subnormal creatures to the prisons. For the sake of the good opinion society would maintain of itself, it sends the latter nowadays to hospitals, sanitaria, or their equivalents, where protection for itself without punishment for them may be practised. But is confinement, or even treatment the solution? For we have to consider what society would lose by cutting such abnormals off from itself, and them from its stimulations. A number of artists have been built like Oscar Wilde, musicians in particular. Without them, would there not be a great gap, a yawning absence, in the world's culture?

Modern diagnosis and modern therapy might have done a great deal for Napoleon, Nietzsche, Julius Caesar, Florence Nightingale, Oscar Wilde. Were they alive today, and willing to submit themselves to scientific scrutiny, the X-ray would tell us of the state of the pituitary and thymus in them, chemical examinations of the blood the condition of the thyroid and adrenals, detailed investigation of the body and mind a flood of light upon their maladies as well as their personalities. Therapy might have relieved Napoleon of his attacks, and so, halting the creeping degeneration of his pituitary, made Waterloo impossible. But then, would we have had the Emperor at all? Would there have been enough of that instability that drives on the genius to his goal? Nietzsche might have been relieved of his headaches, and Caesar of his epilepsy—but then, would not—with correction of the underlying streams of activity on the part of the other glands of the internal secretion to compensate—their peculiar superiority and distinction, and the fruits of their lives as by-products, have been destroyed. Florence Nightingale, too, might have been a softer and more human person. But then would she have revolutionized the practice of nursing? Oscar Wilde possibly might have been made over into a heterosexual. But then would not the world be the poorer without "De Profundis," let us ask? To state the problem in the most general terms: how much abnormality are we to tolerate (I speak, of course, of malignant abnormality, and disregard benign abnormality altogether) for the sake of the valuable that is concomitant? How much are we to stand of that which degrades the germ-plasm while it raises the mind-plasm of the race? The Flowers of Evil. Destroy or modify the roots, change the seed, and the buds will bloom, if at all, not orchids, but dull brown commonplaces.

What means may be licensed for the attainment of a worthy end is perhaps the broadest aspect of the problem. The instruments of Man's ascent to divinity may arouse his instinctive repulsions, dislikes, and destructive passions. The study of the internal secretions is putting and will put the most powerful apparatus for the control of the abnormal into our hands. What are we going to do with them?

It does not follow that because we are beginning to understand the normal that we are to establish one fixed absolute standard of the normal. In view of all the possible mixtures, permutations and combinations of the endocrine glands, that may construct an individual, it is possible to conceive a million types of normals. For normality means harmony, the harmonious equilibrium between the hormones, which tends to continue itself, because it does no harm to itself. So there are all sorts and conditions of men and women who are classed as normals. We need create no inquiry into the value of raising the subnormal to the normal level. It is when we come to consider the possibility of lowering the supernormal (in certain respects) to the normal, that we pause and hesitate. Traditional morality assists not, but hinders us here.

Whatever the race may ultimately decide, it is safe to predict that it is now somewhat possible, and will become more and more possible, to regulate or even check the ills of genius, without interfering with its highest evolution and expression. For example, Bernard Shaw, to take a living man of genius, is pretty visibly a pituitocentric of the well-balanced variety. He has the height, the facial features, the hands, and the sort of mentality that run together in his endocrine make-up. He also has the headaches. It is quite probable that feeding him pituitary gland extract in the proper dosage would relieve him of his headaches. A process might be started in his pituitary, however, that would diminish its extraordinary output which has assisted to make his brain so brilliant. The possibility, nevertheless, is excessively remote as the pituitary predominance in him is so overwhelming, that nothing short of surgery, nature's or the medical graduate's, could really affect that overmastering eminence. The time will come, though it is not yet by a long, long road, when we shall be able to intervene, and perhaps meddle, in nature's most intimate plans. The right of the power to modify, like the power to kill, will be defined and limited by common agreement before that goal will be reached.



CHAPTER XII

APPLICATIONS AND POSSIBILITIES

The knowledge that the shape and action of a man's body as well as his mind depend on the internal secretions inspires the hope of the emergence of a hitherto inconceivable controlling power over human life in the future. For in the wake of chemical discovery there has always come chemical control. The nature of chemical research, the necessity for clear thinking, accurate measurement, and experience in the actual handling of materials, the fundamental tradition and technique of the science, have made and will make the practical applications about which we today may only speculate. What the study of the internal secretions suffers from, at the beginning of the third decade of the twentieth century, is insufficient appreciation of its meaning for mankind. It is true that there are thousands of workers scattered throughout the world contributing their mites to the general store. They increase yearly, almost daily, and their achievements, in spite of an uncritical enthusiasm in some quarters and a semi-charlatanism in others, have been and continue magnificent. But they are pecking at a mountain which requires organized, massive, engineering organization for its blasting.

The crying need is for an international institute, endowed and equipped for investigation upon the proper scale, with all the available appliances and methods already worked out and at hand. Such an institution would possess the right chemical laboratories for the making of blood analyses, metabolism examinations, and tests of endocrine functions. There would be X-ray machines and experts to radiograph the pituitary, pineal and thymus glands when possible. There would be psychologists to carry out intelligence tests, determine emotional reactions, and group mental aberrations, deficiencies and defectives. There would be statisticians, trained in biometrics, to criticize and compare data obtained. There would be anthropoligists to note and measure variations in angles and curves, ratios and quotients of the external conformation of the body. Internists would record the history and status of the organs and viscera. There would be librarians to collect, abstract and collate the vast, accumulating literature. In short, the mystery of personality, the most marvelous, complex, and variable process in the universe, would be attacked and at length penetrated systematically and persistently, with the ideal of absolute control of its composition as the goal in view.

The nature of the researches? They would be infinite in their variety and significance. Their practical by-products, dropped in the pursuit of knowledge by the scientist, as Atalanta's lover the golden apples in his race, to assuage the scent of the hard-headed business man, would be profitable enough for any country in peace or war, to pay for itself ten times over and at compound interest. A volume could be filled with suggestions for interesting and promising investigations. But we may glance at some of the immediately useful aspects that might exercise those concerned with the everyday life of men, women and children.

THE ENDOCRINE EPOCHS OF LIFE

There is no more famous classifications of the epochs of life that mark off the milestones of the individual's evolution than Shakespeare's Seven Ages. So different is he at those different stages of his development, so changed his body and mind that it has become a part of popular physiology that we are entirely made over every seven years, and that no cell in the organism lasts longer than that. The tradition certainly does not apply to the brain and nervous system, for the number of brain cells is fixed at birth, and cannot be increased, only decreased, because they are too highly specialized to reproduce themselves.

What transfigures the individual as the years go by is no simple wear and tear of the tissues, nor the replacement of old cells by new. It is the rearrangement of relationships among the ductless glands, the shifting of influences from the predominant to the subordinate, and vice versa, in the constellation of the internal secretions, that determines the unfolding of the personality. The transformations raise doubt sometimes as to the reality of personal identity. What actually happens in the changes from childhood to adolescence, from adolescence to maturity, and so on, is the sloughing of one internal glandular dominance for another.

Growth, as a general name for the mutations, the ensemble of somatic and psychic differentiation, from year to year, passes through five epochs that are standard for the normal. The normal is the being who harmonizes with his environment, and yet reacts with it because of recurring needs within him. His endocrine equation settles what is unique and different in him. But the gland which flourishes during the epoch as its time of triumph, when it has its day, determines what makes him like his fellows.

From this point of view it becomes permissible to speak of the five Endocrine Epochs. Similarities and resemblances of mind and body between people at a given period of life, childhood, youth, maturity must be put down to their common government by the salient endocrine of the epoch. So one may list:

Infancy as the epoch of the thymus Childhood as the epoch of the pineal Adolescence as the epoch of the gonads Maturity as the epoch of whatever gland is left in control as the result of the life struggle. Senility as the epoch of general endocrine deficiency.

Infancy as the epoch of the thymus explains why, in any given geographic locality, the babies look alike and act alike. Specialists in the observation and treatment of infants have noted that not until after the second year is any tendency to differentiation discernible to any extent among them. It is only after the second year, or somewhere around that time, that the child begins to individuate, and distinct individual traits and a personality manifest their outlines. The thymus is the great inhibitor of all the glands of internal secretion. By its checking activity upon the other members of the endocrine system, the thyroid and pituitary in particular, it gives the baby time to grow in bulk, which is its chief business during the first two years of its existence. It quadruples its birth weight. The brain and nervous system complete their growth in mass by the end of the fourth year. Recall the experiments of Gudernatsch working with tadpoles, who showed that feeding with thymus produced giant tadpoles whose metamorphosis into frogs was inhibited, while feeding thyroid produced frogs the size of flies. Differentiation occurred without the preliminary increase in mass usual. As differentiation and bulk thus appear antagonistic, at least at the beginning of growth, the function of the thymus, at a maximum during infancy, seems then to be to restrain the differentiating endocrines, until sufficient material has been accumulated by the organism upon which the differentiating process may work.

After the second year, the thymus begins to shrink. That is to say, officially its involution begins. Careful dissection will demonstrate some thymus tissue even in a normal subject up to the fourteenth year. This refers to the average normal, for the large thymus may continue large and grow larger after the second year in the type of individual designated in a preceding chapter as the thymocentric.

If the thymus retrogresses after the second year, what takes its place as a brake upon the forward driving impulses of the other endocrines? We have every reason for assigning that role to the pineal. It performs its service mainly, in all probability, by inhibiting the sex stimulating effect of light playing upon the skin. Since it is especially a sex gland inhibitor, the thyroid and pituitary become freer to exert their influences than under the thymus regime. And so we find that it is after the second year that thyroid and pituitary tendencies manifest their effects. The Pineal Era, from the second to the tenth to fourteenth years, remains to be investigated from a number of viewpoints interesting to the parent, the educator, and the student of puericulture. Precocity is directly related to early involution of the pineal. For just as the thymus involutes at the second year, the pineal atrophies before the onset of adolescence.

Adolescence is the period of stress and strain throughout the somatic and psychic organism because of the volcanic upheavals in the sex glands. The history of the individual is dominated by them up to twenty-five or so, when maturity commences in the sense of a relative sex stability. They continue to exert a powerful pressure throughout maturity. But life episodes and crises, diseases, accidents, and struggles, experiences of pleasure and pain, as well as climatic factors, settle finally which endocrine or endocrines are left in control as a consequence of the series of reactions the period of maturity may be analyzed into.

THE INTERPRETATION OF SENILITY

Senility inevitably follows maturity, not as night follows day by a mathematical necessity, but because of the process of degeneration which ultimately overtakes all the glands of internal secretion, dominant as well as subordinate. Just why the degeneration must occur no one can say. Injury to the endocrine organs of one sort or another, ranging all the way from emotional exhaustion to bacterial infection, is the reason usually considered sufficient. Just why recuperation and regeneration do not preserve them in the elderly as they do in youth is a problem to be solved when we understand the laws of regeneration, at present almost totally beyond our control. Some say that it is a matter of the wear and tear of our blood vessels, those rubber-like tubes which transport food and drainage with nonchalant equanimity to all cells as long as they last. In the classic phrase: a man is as old as his arteries, ergo his ductless glands will be as old as their arteries. And the age of arteries is simply a matter of wear and tear, the resultant of the function which is universal among molecules. Arteriosclerosis, the hardening of arteries, might be the whole story.

But there are certain experiments and considerations which rather confute that easy explanation, or at least make clear that the mystery is not so simple. The work of Steinach, a Viennese investigator, has contributed most to the elucidation of the nonarterial factor in senility. No one has asserted more loudly the importance of the interstitial cells that fill in the spaces between the tubules of the testes in the male, and the follicles of the ovary in females. Rats have been his medium of study, for they are most easily procurable, live fastest, breed, and withstand experimental and operative procedures better than any other animal.

An old rat is like an old man in his dotage. His bald, shrivelled skin covers an emaciated body. His eyes are dimmed by cataracts and his breathing is labored and difficult because his heart muscle has lost its tone. Huddled in a corner, life to him has become concentrated into the desire for a little food, and immobility. If now, something is done to his sex apparatus, a marvelous transformation may be effected. That something no one could predict. It consists in slitting the genital duct, which leads from the germinal cells to the exterior. After the operation, the germinal cells, which grow into the spermatozoa, atrophy and disappear, since they can no longer function. As if released from some restraint, the interstitial cells, however, multiply enormously. With their multiplication, the miracle of rejuvenation is performed.

After some weeks the sluggish currents of being in the rat, which had slowed down as a preliminary to stopping altogether, flow fast and furious. Waves of new chemical substances inundate his cells. And they respond like the fields that border the Nile after the annual flood. All his tissues, skin, muscle, nerve, even bone, are restored. A vitality is created which makes him bound and dart like a youth of his species. In due time, though, senility returns. It is as if a storage battery, recharged, runs down and becomes dead again. Slitting the genital duct of the other testis, causing its interstitial cells to hypertrophy and multiply, repeats the effects of the first experiment. The organism responds again to the new waves of vitality that vibrate through it. That it is recharged is demonstrated again by a revival of sex appetite and sex activity. The female which had become an object of indifference is reinstated as a creature to be sought and pursued. The second period ends in its turn. And now entirely new interstitial glands, in the form of fresh testes removed from a young animal, are transplanted into the body of the old rat. Once more youth returns. But now it burns itself more quickly than even before. An acute exhaustion of the mind appears first. Then all the other phenomena of old age steal back upon the old rat, and senility, firmly established in the saddle, rides him to the end.

THE POSSIBILITIES OF REJUVENATION

Whatever other deductions may be extracted from these experiments, they prove beyond a doubt the existence of an endocrine factor in the process of aging, as well as an arterial. They also demonstrate that the internal secretion of the sex glands, well advertised as it has been as the Elixir of Youth that Ponce de Leon, and Brown-Sequard with so many others, pursued in vain, is not the whole story. For if it was, the duration of the new youth should be another span of life, whereas in actuality it is only a fraction of that time. This fact, together with a number of others, make clear that while the gonads may be the jeune premier of the drama, the vitality of the plot depends upon the other endocrines. Since old age is an exhaustion, permanent and irreparable of all the members of the ductless gland directorate, the reason becomes clear for the temporary quality of the rejuvenation effected by the procedures of Steinach.

Practically, then, the question at once arises: which of the glands in particular are involved? There is first that ubiquitous agent in the system, the thyroid. Chemical analysis of it has shown that the iodine content decreases with the age of the individual, and becomes specially low after forty. It is after the menopause in women that myxedema, the disease of complete degeneration of the thyroid, and of the physical and mental faculties, is most frequent. The thyroid of old people exhibits, in varying degrees, signs of a similar degeneration. Thyroid feeding, properly controlled, will clear up certain of the deteriorations of mind and body observable in the aged. The grossness of the features lessens, a number of the pains go, muscular endurance increases, memory and intelligence do not remind one so forcibly of the old dotard in his second childhood. Of course the improvement at present achievable is only relative. But in the prematurely aging, decay invading a half accomplished maturity, marvels have been achieved at times with feeding of the gland.

The pituitary, too, begins to retrogress after the period of maturity. And an early retrogression means a short maturity. In women, the onset of an obesity, and coincidently, of a lazy and dull morale, coincides with this declension of the pituitary powers. All the glands of internal secretion, in fact, shrink and shrivel as old age advances. Only, as in other relationships, the predominating endocrine stamps its signature more visibly upon the documents of decadence than the others. Pituitary types, as said, get fat and slow, thyroidal become bulky and stupid or thin and sour, the adrenal dark, shrunken and forever tired of life. So type emerges, even in all-around glandular deficiency.

The problem of rejuvenation is the problem of recharging, or replacing all of the glands of internal secretion, at least the most important, the thyroid, the pituitary and the adrenals, as well as the gonads. Longevity is perhaps largely a matter of preventing, or postponing their wane. Beside, there is the prophylaxis of bacterial infections, and their all embracing corrosions—which, too, have an endocrine aspect.

Persistence of youth or juvenility may be manufactured by nature in two ways. There may be a persistence of early glandular predominances. We have seen what happens to the thymocentric. That a pineal-centered juvenile or infantile type exists may be safely predicted. Nature's only other mode of securing perpetual youth seems to be by prolonging the time allotted to the sex gland crescendo.

As for the golden age of maturity itself, what humdrum people and poets have despised as middle age, the margin of reserve of the ruling hormone is a quantity almost malleable in our hands, but still to be regarded with respect as a hard cold proposition by the physiologist. In general, the continuance of any stage of development means the maintaining of the glandular administration peculiar to it. So the chubby debonair irresponsible whom nothing can touch is happy in the possession of a pineal uncorrupted by the years, while the genius who can turn out his best work at sixty-five must thank his pituitary for standing by him to the end.

THE SCIENCE OF PUERICULTURE

There is a specialty now growing in the womb of science which in its own good time will come to fruition as the study of the child's needs or puericulture. Even today there exists a scientific basis for the formulation of the principles upon which every child should be brought up. Though we have had marvelous results from the campaigns to lower infantile mortality, most of what has been done has been medical in its interest, and so largely negative in its accomplishments. The removal of the causes of evil no doubt gives the good its opportunity. But how to raise a child, endowed with satisfactory ancestral stuff, as a Grade A normal or supernormal, still remains to be erected into an exact science.

A number of attempts have been abortive in this field. Why they have failed to arouse the ardor of the parent has puzzled some of the pioneers. Child-culture as the foundation of all systems of education has continued more or less of a hope rather than an achievement because of a lack of appreciation of the different constitutional varieties of children. A certain amount of attention has been lavished upon children needing special attention, those mainly suffering from insufficient development of one sort or another. In the last decade or so, an endeavour to focus upon the exceptional child, exceptional in intelligence or some special creative endowment, has started an interesting movement. All of them have suffered from the fallacies and troubles of the pure psychologist who would handle mind as an entity in a vacuum.

A realization of the different physical and psychic educational needs of various children will arrive only when we see them as built differently. Just as shoddy and silk, cotton and wool, alone or in combination, all possess different qualities as wearing material, so different children have varying capacities for the wear and tear of education. The endocrine classification of the human race, applied to children, will here yield a harvest to the educator and to the country. Nothing is more evident than the diversified nature of the needs of the various internal secretion types, once they are realized as such.

The history of a thymocentric type, for instance, is predictable from the very first few months of his life. Difficulties in feeding, in habit formation and adaptation, in the reaction to infections, in social play and so on, one may expect for him. The course of events for the other endocrine types also follow laws of their own. It will be above all in the understanding of children, their make-up, reactions and powers, that the biologist will achieve some of his finest triumphs.

The educator will have to take account of the state of the pituitary in estimating the normal intelligence, or influencing the abnormal or subnormal intelligence. As well will he have to consider the thyroid in the child whose conduct is refractory, even though his proficiency in his studies is excellent. And the condition of the adrenal will be ascertained in the types that tire easily, and that seem unable to make the effort necessary or desirable. Periodic seasonal and critical fluctuations in the equilibrium among the hormones will have to be taken into account in the explanation of what have hitherto been put down to laziness, naughtiness, stupidity, or obstinacy.

A child's capacity for education, essentially its capacity for the highest and most productive kind of life, is limited by inherent factors. These factors are two: the quality of the nerve tissue, its ability to make a number of associations, and the quantity of the internal secretions, measured by the maximum obtainable in a given situation. These inherent factors explain, too, why children born and bred in virtually the same environment show the most extreme differences in educability. That the differences are inherited was made evident by Galton's finding that the chance of the son of an eminent man exhibiting eminent ability was 500 times as great as that of the son of a man taken at random.

Every baby, then, is born with a combination of nerve cells and ductless glands which determine its capacity for mental development, that might never be realized, but could never be exceeded. If, in any family, minor differences in educability are observed, they can be put down to disturbance of these two factors occurring after the fertilized germ cell had started to divide and reproduce itself. But any marked falling off in either the nervous or endocrine factors has to be considered pathologic, due to an impairment of them by adverse environment.

Recent studies have amply established that the proportion of certifiable mental defectives, and of a much larger class, the subnormal but not certifiable class, is progressing by leaps and bounds. It is perhaps the most absurd frailty of our present system of education that it takes almost no account of innate differences in educability. To spend money upon the teaching of these children along lines where they are unteachable is not only waste pure and simple, but crime, for it deprives the educables of their just due.

These, of course, are the crude and simple lines upon which the finer and more complex evolution of the endocrine problems of the school child will build. The fine art of education itself is crude and gross and simple compared with what it might be, even as a beginning. The science of education has yet to begin, as the offspring of that science of the future, to which knowledge of the internal secretions will contribute no little, the science of puericulture.

VOCATIONAL EDUCATION

It is difficult, indeed, to avoid becoming merely enthusiastic upon the possibilities of the applications of the endocrines to the educational domain. Happiness for the average individual consists of a double success—success in his vocation (chosen or forced upon him) and success in his sex life. A certain hue and cry has been raised in the last few years concerning the vast and overwhelming importance of sex in the happiness and even in the successes of a man's everyday life. And no doubt there is a relation. Sublimation plays its part in the explanation of vocational idiosyncrasies. The fact, however, that perfect success in sex may occur with absolute failure in the career, however, splits the problem for good into its realities: a physiologic aspect as well as a psychologic.

So, as school education will have to take serious account of endocrine anomalies and possibilities, will the institution which selects and trains for a career. Vocational misfits have aroused the ardor of our efficiency experts. And again, the sweeping psychological attack has beaten its head against the stonewall of ignorance of constitutional predispositions and tendencies of material. The attempt to erect psychologic types for vocational selections could never make much headway because it could only flounder in a swamp of metaphors, product of the vices of its methods. Not that anyone would wish to discard at all the psychologic mode of approach. But no science, in the sense of accurate examination, was possible, in the matter of classification for vocation, without the insight into the physiology of the candidate that the analysis of his endocrine formula will provide.

One need not dilate upon the value of such an examination. Civilization has not yet learned how to pick its personnel. And so artists and scientists, philosophers and politicians, financiers and religious leaders, arise and survive by the operation of the laws of probabilities and chances, rather than by any intelligent selection and cultivation of material. The case, indeed, is simply a subdivision of the vast subject: haphazard muddle in the conduct of life. A cry has been raised for the superman, and a cry has been raised for a method of anthropometry. For the lack of these two, it has been said, all governments have been doomed to defeat. The study of the endocrines will by no means supply a panacea. But as it will furnish a means of approach to the determination of how men and women are built, and why they are built differently, no one can gainsay the tremendous advantages to the nation that will proceed to classify its population accordingly, and know its strength and weakness in terms of the actual generators of success and failure.

Suggestions have been offered in the preceding pages of concrete applications of endocrine knowledge to the understanding of behaviour, of the genius and commonplace, criminal and Puritan. And in the chapter on historic personages, we tracked some of the story in detail. This vein when explored will quarry untold riches. It has been observed that financiers of mark, like great musicians, are special pituitary types. Also that the financiers are voracious meat eaters and the musicians inordinately fond of sweets. Differences in anterior and posterior predominances might account for this. That we are playing here with no phantasy is proven by the fact that we can effect changes of tastes as well as of intellectual direction by appropriate feeding of various glandular extracts. Just as much, indeed, as we can influence sex susceptibility, and the reaction to sex stimulation, by the artificial introduction from without of the proper hormones.

FATIGUE AND INDUSTRY

In industry, business and profession, the biologist will come more and more to be called as consultant. Labor unions as well as the large employers of labor, and their employment managers have given much thought to the problem of fatigue. Just what fatigue is, why different individuals tire at different rates, why some are constructed for monotonous routine while others must have constant variety and change, the relation to accidents and to quantity output, are a few of the major lines of inquiry upon which the endocrines obviously have a large bearing. To the employment manager, labor turnover and the selection of personnel are adjacent fields of research.

Fatigue as an endocrine deficiency—a depressed state of one or more of the glands of internal secretion, abolished when its normal functioning is restored—is a general principle from which departures of exploration of sub-problems will proceed. An endocrine organ will secrete at a certain rate. When it is stimulated excessively, it will eject extra amounts of its secretion. How long the period of excessive stimulation may last must depend upon the secretion potential or margin of reserve of the cells, varying from organ to organ, and from individual to individual. After that, exhaustion and failure follows, with the onset of the symptoms of fatigue.

A pretty demonstration of this process has been worked out in the electrical stimulation of muscle. If a muscle, say the biceps, is irritated by an electric current, it will contract. As the strength of the current is increased, the degree of contraction becomes greater. A sort of stepladder effect of increasing contractions may be thus obtained. After a time, the electric shocks cannot cause a greater contraction, but only a lesser. And if continued, the muscle will cease to function because of fatigue. If now, when the muscle begins to lag in its response, and its contractions to decrease, one injects into a vein extracts of thyroid, parathyroid, or adrenal glands, they will immediately reinvigorate the failing contractions. The injections must be made before the fatigue is carried to the point of absolute exhaustion. It follows that these glands normally pour into the circulation substances which counteract the effect of fatigue substances, and in fact make possible muscular recuperation from fatigue throughout the day as well as in emergencies and crises.

Fatigue, conventionally recognized, is something acute and urgent. As such it means a violent draining of the endocrine wells. But there is also a chronic fatigue, which has been dignified with the name of Fatigue Disease. Bernard Shaw once asked for someone to tell him the name of the germ causing the symptoms of overwork. That being impossible, he will have to be satisfied with the answer that it is not a germ, but an internal secretion, or rather a defect of internal secretion that is the cause.

Whether or not the adrenals have been damaged by past experiences, and upon their capacity to respond to the necessities of an occasion, fatigue reactions primarily depend. A quotation from Sir James MacKenzie, most distinguished of modern English students of medicine, summarizes the matter neatly. "Abelous, and Langlois and Albanese have studied the relation of the adrenal bodies to fatigue.... They infer that the muscular weakness following removal of the adrenals is due to toxic substances. In view of our present knowledge of the physiological action of adrenaline in its various forms, it seems more probable that the weakness is to be explained by the absence of the normal tone producing internal secretions of the bodies in question." In other words, the adrenals regulate muscle tone. They produce nature's tonics for weary tissues. The chronic lassitude of thousands of our generation, suffering from "that tired feeling," may be put down to chronic adrenal insufficiency.

It requires no superlative imagination to see that an adrenal poor subject does not belong upon a job that involves muscle stress over a long period, or indeed fatiguing conditions of any sort. Nor that a thyroid poor individual is not the best choice for a position that demands a keen, alert body and mind. In the selection of executives, the nature and stamina of the pituitary will undoubtedly be taken very seriously in the near future.

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.

Narcotism, the craving for narcotic or stimulant drugs, and its subvariety, alcoholism, has been found most often among the thymocentrics. Any type of endocrine inferiority, interfering with success in life, may lead to the habit of drug addiction as one way out. But the blood and tissues of the thymocentric appear to become habituated to the narcotic stimulant more easily than the other types, and so to demand it with a physical imperative comparable to the food or sex urge. Among artists, philosophers and statesmen, on the other hand, actively productive and so contrasted with criminals and degenerates drug addiction has frequently been a mode of endocrine compensation. That is, the drug produced temporarily the effects of the internal secretion lacking or insufficient. Thus the effects of cocaine may be compared with the effects of thyroid. But while there is a normal mechanism for thyroid detoxication, the cocaine or heroin derivatives mark the tissues permanently with their scars and deform the personality.