34O INTERNAL SECRETION 



exercise a considerable influence upon the general processes of 

 growth. 



In the meantime, a large number of physiological, patho- 

 logical and experimental facts have come to light which show the 

 influence of the sexual glands upon the hypophysis. Comte and 

 a number of later authors (Launois and Mulon, Guerrini, Morandi 

 Cagnetto, Thaon) found that the hypophysis regularly enlarges 

 during pregnancy, and that during lactation it returns to the 

 normal. These changes were from the first regarded as signs of 

 hyperfunction, and the discoveries of Erdheim and Stumme after- 

 wards supplied incontrovertible evidence of hypophysal hyper- 

 trophy during pregnancy and of the changes which take place 

 in the structure of the organ. Fichera's valuable work next 

 showed that the changes in the hypophysis during pregnancy are 

 due to a reduction of activity on the part of the ovary. After 

 the castration of male and female animals, he found hyperplasia 

 and hypertrophy of the hypophysis which exactly resembled the 

 hypertrophy of pregnancy. The weight of the hypophysis in 

 capons and oxen, as well as in castrated female animals, was twice 

 as large as in normal animals, and this hypertrophy was reduced 

 by the exhibition of extract of the sexual glands. By examina- 

 tion of the skulls of skeletons, and by means of skiagrams of 

 living castrated animals, Tandler and Gross next showed that 

 there was anatomical enlargement of the sella turcica. In three 

 animals from which the testicles or ovaries had been removed 

 several years previous to death, Rossle found considerable en- 

 largement of the hypophysis; as also in one animal, the uterus of 

 which had been extirpated four days previously. The association 

 of hypophysal hypertrophy with aplasia of the genitals and with 

 the results of castration, was conclusively proved by Jutaka-Kon's 

 investigations. 



If the excessive growth of the hypophysis in acromegaly is 

 considered in the light of these facts, it is readily conceivable that, 

 as certain authors believe, the derangement of the internal secre- 

 tory function of the sexual glands may be the primary cause of 

 the condition ; that it gives rise to secondary proliferation of the 

 hypophysis ; and that the latter, in its turn, brings about the 

 typical changes of acromegaly. Stumme regards the anomaly of 

 the internal secretory function of the sexual glands as a primary 

 metabolic disturbance leading, where there is congenital pre- 

 disposition, to tumour formation in the hypophysis. It cannot 

 be denied that, in many of its aspects, the clinical complex of 

 acromegaly suggests a primary affection of the sexual glands. 

 It is suggestive in this connection, that the development of 

 hypophysal tumour and of acromegaly are frequently preceded 

 by symptoms of chlorosis, a condition which has been regarded 

 as connected with the genital tract. On the other hand, there 

 are reliable observers who affirm that, in many cases, the changes 



