History of endocrinology
The study of endocrinology began when Berthold noted that castrated cockerels did not develop combs and wattles or exhibit overtly male behaviour.[5] He found that replacement of testes back into the abdominal cavity of the same bird or another castrated bird resulted in normal behavioural and morphological development, and he concluded (erroneously) that the testes secreted a substance that "conditioned" the blood that, in turn, acted on the body of the cockerel. In fact, one of two other things could have been true: that the testes modified or activated a constituent of the blood or that the testes removed an inhibitory factor from the blood. It was not proven that the testes released a substance that engenders male characteristics until it was shown that the extract of testes could replace their function in castrated animals. Pure, crystalline testosterone was isolated in 1935.[6]
Although most of the relevant tissues and endocrine glands had been identified by early anatomists, a more humoral approach to understanding biological function and disease was favoured by classical thinkers such as Aristotle, Hippocrates, Lucretius, Celsus, and Galen, according to Freeman et al[7], and these theories held sway until the advent of germ theory, physiology, and organ basis of pathology in the 19th century.
In 1902 Bayliss and Starling performed an experiment in which they observed that acid instilled into the duodenum caused the pancreas to begin secretion, even after they had removed all nervous connections between the two.[8] The same response could be produced by injecting extract of jejunum mucosa into jugular vein, showing that some factor in the mucosa was responsible. They named this substance "secretin" and coined the term "hormone" for chemicals that act in this way.
[edit] Endocrinology as a profession
Although every organ system secretes and responds to hormones (including the brain, lungs, heart, intestine, skin, and the kidney), the clinical specialty of endocrinology focuses primarily on the endocrine organs, meaning the organs whose primary function is hormone secretion. These organs include the pituitary, thyroid, adrenals, ovaries, testes, and pancreas.
An endocrinologist is a doctor who specializes in treating disorders of the endocrine system, such as diabetes, hyperthyroidism, and many others (see list of diseases below).
[edit] Work
The medical specialty of endocrinology involves the diagnostic evaluation of a wide variety of symptoms and variations and the long-term management of disorders of deficiency or excess of one or more hormones.
The diagnosis and treatment of endocrine diseases are guided by laboratory tests to a greater extent than for most specialties. Many diseases are investigated through excitation/stimulation or inhibition/suppression testing. This might involve injection with a stimulating agent to test the function of an endocrine organ. Blood is then sampled to assess the changes of the relevant hormones or metabolites. An endocrinologist needs extensive knowledge of clinical chemistry and biochemistry to understand the uses and limitations of the investigations.
A second important aspect of the practice of endocrinology is distinguishing human variation from disease. Atypical patterns of physical development and abnormal test results must be assessed as indicative of disease or not. Diagnostic imaging of endocrine organs may reveal "spots," called incidentalomas, which do not represent disease.
Endocrinology involves caring for the person as well as the disease. Most endocrine disorders are chronic diseases that need life-long care. The most common of these is diabetes mellitus. Care of diabetes and other chronic diseases necessitates understanding the patient at the personal and social level as well as the molecular, and the physician-patient relationship can be an important therapeutic process.
Apart from treating patients, many endocrinologists are involved in clinical science and medical research, teaching, and hospital management.
[edit] Training
There are roughly 7,000 to 8,000 endocrinologists in the United States. Endocrinologists are specialists of internal medicine or pediatrics. Reproductive endocrinologists deal primarily with problems of fertility and menstrual function - often training first in obstetrics. Most qualify as an internist, pediatrician, or gynecologist for a few years before specializing, depending on the local training system. In the U.S. and Canada, training for board certification in internal medicine, pediatrics, or gynecology after medical school is called residency. Further formal training to subspecialize in adult, pediatric, or reproductive endocrinology is called a fellowship. Typical training for a North American endocrinologist involves 4 years of college, 4 years of medical school, 3 years of residency, and 3 years of fellowship.
[edit] Professional organizations
In North America the principal professional organizations of endocrinologists include The Endocrine Society (www.endo-society.org), the American Association for Clinical Endocrinology (www.aace.com), the American Diabetes Association (www.diabetes.org), the Lawson Wilkins Pediatric Endocrine Society (www.lwpes.org), American Thyroid association ( www.thyroid.org ), and the Academy of Clinical Thyroidologists,(www.thyroidologists.com).
In the United Kingdom, the Society for Endocrinology (www.endocrinology.org) and the British Society of Paediatric Endocrinology and Diabetes (www.bsped.org.uk) are the main professional organisations.
The European Society of Paediatric Endocrinology [1] is the largest international professional association dedicated solely to paediatric endocrinology.
There are numerous similar associations around the world.
2007-02-27 02:43:04
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answer #4
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answered by i'm a captain of my own jour 2
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