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Preface
- Johns Hopkins University Press
- Chapter
- Additional Information
This book tells a life story, but it isn’t a biography. It paints a family portrait, but not of a human family. Instead, this book depicts the world’s most famous hormone, adrenaline, and its chemical family, the catecholamines (pronounced cat-a-COLA-means, or, if you are British, cat-a-coal-AYmeans ). They are part of you. They have kept you alive and are keeping you alive now as you read this, just as they sustained your ancestors from the beginning of mammalian time. Through them I hope to teach you a bit about the “wisdom of the body,” as the great American physiologist, Walter B. Cannon, titled his classic book about seventy-five years ago. I use the term life story quite deliberately here. Adrenaline exemplifies a type of chemical called biogenic. The word biogenic has a double meaning. Biochemists use it to signify that living things make these chemicals. Another meaning—and a main message of this book—is that higher organisms depend crucially on these chemicals for life, because catecholamines enable regulation of the body’s “inner world” by the brain. The year 2001 marked the centennial of adrenaline’s discovery. Adrenaline was first purified, its structure was deduced, and attempts to measure it began in the early twentieth century. Indeed, adrenaline was the first hormone ever to be identified and produced in a laboratory. During the decades that followed, adrenaline acquired a unique mystique and folklore, which, for reasons that were largely technical, outpaced its science. Injected as a drug, adrenaline potently produces obvious effects. The skin turns pale, the heart pounds, the blood pressure rises, and the individual feels energized . Because of this potency, however, the plasma of healthy humans at rest contains remarkably low levels of adrenaline—a few millionths of a millionth of a gram per milliliter—measurable only during the past thirty years or so, since the introduction of sufficiently sensitive, specific assay methods. Inferences from the indirect physiological evidence of the early Preface twentieth century led to speculative notions, then to legends, and then to pulp myths. The technical problem of actually measuring levels of adrenaline directly in the bloodstream, rather than indirectly via adrenaline’s effects, had consequences beyond obtaining scientific understanding about this particular hormone. The coinage of science is discovery, and novelty makes for easy sales. After the measurement of adrenaline levels posed a seemingly insurmountable challenge, biomedical researchers turned to other, newly discovered compounds in a succession extending until the present—insulin , adrenocortical steroids, serotonin, vasopressin, the renin-angiotensinaldosterone system, hypothalamic releasing factors, prostaglandins, kinins, neurotrophic factors, atriopeptins, endothelins, nitric oxide, leptin, orexins, aquaporins, and an imposing, expanding array of cytokines. In doing so, researchers followed a long tradition of studying such compounds one at a time. Dwelling on the workings of single systems, using single effector chemicals, is always easier and cheaper than focusing on interactions among multiple systems that use different effector chemicals. The emphasis on single systems in medical science comes from the belief that one best acquires knowledge by dissecting a problem into its component parts; reassembling the parts presumably would solve the problem. This approach is called reductionism. The technical difficulty in measuring adrenaline levels, coupled with the reductionist tradition in medical science, retarded development of integrative approaches that have only recently begun to attract bioscientists. Scientific integrative medicine is not a discipline, a group of disorders, or a method of treatment but an approach, a way of thinking. Scientific integrative medicine uses systems concepts to explain disease processes and develop strategies to treat, prevent, or palliate them. It emphasizes disorders of the multiple interacting systems that regulate the body’s inner world. Scientific integrative medicine asks researchers and clinicians to consider more than one system at a time, as assessed by measuring levels of more than one chemical effector at a time. One of those chemical effectors—but a very important one—is adrenaline. For more than a century, from the discovery of adrenaline as the active principle of the adrenal gland, to the identification of norepinephrine, adrenaline’schemicalfather,astheneurotransmitterof thesympatheticnervous system, to the elucidation of the role of dopamine, adrenaline’s chemx PREFACE [3.145.206.169] Project MUSE (2024-04-18 00:52 GMT) ical grandfather, as a neurotransmitter in the brain, research based on the adrenaline family has proven remarkably consistently fruitful and led to many Nobel Prizes. I believe that the evolution of scientific integrative medicine...