ENDOCRINE HOMEOSTASIS IN CLINICAL PEDIATRICS

[摘要] SIX MONTHS or a year ago it might have been appropriate to introduce these remarks with comments on the fact that endocrinology encompasses much more than the diagnosis and therapy of such primary endocrinopathies as pituitary gigantism, thyrotoxicosis, sex precocity and the like. The remarkable current reports on the therapeutic actions of adrenal cortical hormones and of pituitary adrenocorticotropic hormone (ACTH) already have shown that there may be as much or more endocrinology in a patient with rheumatoid arthritis, ruptured appendix, pneumonia, status asthmaticus or thermal burn as in the pituitary dwarf or eunuch. In fact it appears safe to say that there is hardly an organ or structure in the body that is not influenced directly or indirectly by endocrine forces or a clinical condition that is not accompanied by functional or homeostatic alterations on the activity of some endocrine gland.These homeostatic reactions constitute to a major extent, as Walter Cannon once put it, "the Wisdom of the Body." Most of the time they work so efficiently that we forget that they exist and are playing an important role in bodily defense and recovery reactions. This thought may be worthy of illustration by a few arbitrarily selected situations. In presenting these illustrations I wish to emphasize that they represent the cumulative researches of many investigators working in many laboratories over a considerable period of time.Figure 1 presents observations on a child with psychogenic polydipsia who was subjected to water restriction. This restriction was accomplished by omitting all fluids except those contained in solid foods. It is seen that such a physiologically normal individual is able quite effectively to conserve body H2O (weight) and to prevent hemoconcentration (elevation in blood hemoglobin) by increasing urine solute concentration (specific gravity).

[学科分类] 儿科学