HYPOPHYSIS CEREBRI 319 



The only decisive observations are those obtained from later 

 experiments carried out by Paulesco's method. Paulesco and 

 Gushing have described the results of such hypophysectomies. I 

 employed the method myself in combination with Silbermark, as 

 well as with Leishner and Denk. 



Paulesco performed total hypophysectomy with twenty-two 

 dogs and two cats. His animals lived for ten to forty-eight hours 

 at most. The autopsy revealed neither haemorrhage nor suppura- 

 tion at the site of operation, and the other findings were also 

 negative. The autopsy showed that, in fourteen dogs, extirpation 

 was not complete, portions of hypophysis tissue of varying size 

 having been left in situ. These animals lived three to seven to 

 ten days; where the amount of tissue left behind was large, they 

 lived longer (seventeen, twenty-three, sixty-seven, 151, 158, 196, 

 an d 395 days). The almost complete suppression of hypophysal 

 activity was not revealed by any marked symptoms, and Paulesco 

 found that even those animals which survived for a considerable 

 time did not show any signs of trophic disturbance. 



In three dogs, a portion of the anterior lobe only was removed. 

 These animals lived without special symptoms for twenty-three, 

 sixty-six, and 932 days respectively. The complete destruction of 

 the cortical substance of the anterior lobe with the thermocautery 

 proved fatal to seven dogs, death following as rapidly as after 

 total hypophysectomy. Five animals survived the removal of 

 the posterior lobe for thirteen and sixty-nine days, eight months, 

 and two years respectively ; there were no pathological signs, and 

 the animals eventually died from accidental affections. 



The loosening of the hypophysis from the sella turcica was 

 found to be quite negative. According to Paulesco, death follows' 

 separation of the hypophysis from the base of the brain by resec- 

 tion of the peduncle, as rapidly as after complete, or almost 

 complete, extirpation. That this result is not due to the opening 

 of the third ventricle, is proved by the fact that the opening of 

 the third ventricle alone is not followed by death. Neither can 

 the fatal result be ascribed to the lesions at the base of the brain, 

 for in the control animals such lesions produced only symptoms 

 of motor stimulation, and these were invariably absent after 

 removal of the hypophysis. 



Paulesco concluded that the hypophysis is an organ which is 

 essential to life, and that the suppression of its function is rapidly 

 followed by death. In his opinion, the vital portion is the cortical 

 substance of the epithelial anterior lobe. 



Gushing confirms Paulesco's view of the vital character of 

 the hypophysis. Nevertheless, his experiments seem to show 

 that the results of total extirpation are less rapid in young dogs 

 than in old. He was able to prolong the lives of his animals by 

 the previous or simultaneous transplantation of the anterior lobe, 

 as well as by the injection of extract of the anterior lobe. Accord- 

 ing to Gushing, total extirpation of the hypophysis is followed 



