Читать книгу Essential Endocrinology and Diabetes - Richard I. G. Holt - Страница 15

The term ‘hormone’, derived from the Greek word ‘hormaein’ meaning ‘to arouse’ or ‘to excite’, was first used in 1905 by Sir Ernest Starling in his Croonian Lecture to the Royal College of Physicians. However, endocrinology is built on foundations that are far older. Although Aristotle described the pituitary, gigantism, caused by excess growth hormone (GH) from the somatotrophs of the anterior pituitary, was referred to in the Old Testament. It was only two millennia or so later in the 19th century that the gland’s anterior and posterior components were appreciated by Rathke, and Pierre Marie connected GH‐secreting pituitary tumours to acromegaly and excess growth.

Diabetes was recognized by the ancient Egyptians. Areateus later described the disorder in the second century AD as ‘a melting down of flesh and limbs into urine’. Consequently, diabetes comes from the Greek word meaning ‘siphon’. The pancreas was only implicated relatively recently when Minkowski realized in 1889 that the organ’s removal in dogs mimicked diabetes in humans.

The roots of reproductive endocrinology are equally long. The Bible refers to eunuchs and Hippocrates recognized that mumps could result in sterility. Oophorectomy in sows and camels was used to increase strength and growth in ancient Egypt. The dependence of endocrinology on technology is also long standing. It took the invention of the microscope in the 17th century for Leeuwenhoek to visualize spermatozoa and later, in the 19th century, for the mammalian ovum to be discovered in the Graafian follicle.

During the last 500 years, many endocrine organs and systems (‘axes’) have been identified and characterized. In 1564, Bartolomeo Eustacio noted the presence of the adrenal glands. Almost 300 years later (1855), Thomas Addison, one of the forefathers of clinical endocrinology, described the consequences of their inadequacy. Catecholamines (epinephrine/adrenaline and norepinephrine/noradrenaline) were identified at the turn of the 19th century, in parallel with Oliver and Schaffer’s discovery that these adrenomedullary substances raised blood pressure. This followed shortly after the clinical features of myxoedema were linked to the thyroid gland, when, in 1891, physicians in Newcastle‐upon‐Tyne treated hypothyroidism with sheep thyroid extract. This was an important landmark, but long after the ancient Chinese recognized that seaweed, as a source of iodine, held valuable properties in treating swelling of the thyroid gland (‘goitre’).

These early aspects of clinical endocrinology and diabetes tended to rely on recognition and description. Since then our understanding has advanced through:

 Successful quantification of circulating hormones

 Molecular unravelling of complex hormone action

 Mechanistic identification of pathophysiology underlying endocrine dysfunction

 Molecular genetic diagnoses

Some of the landmarks from the last 100 years are shown in Box 1.2. Endocrinology and diabetes is notable for researchers who have been awarded the Nobel Prize for Medicine, Physiology or Chemistry for their landmark discoveries (Table 1.1).