354 INTERNAL SECRETION 



Tumour forms of the most varied description glioma, sar- 

 coma, carcinoma, and tumours composed of different kinds of 

 tissue have all been observed in the pineal gland. 



Clinical Signs of Pineal Affection. Disease of the pineal 

 gland is accompanied by certain very characteristic clinical signs, 

 which are to an extent analogous with those which accompany 

 pituitary disease. 



Total destruction of the pineal gland, such as may be brought 

 about by malignant tumours, was in six cases accompanied by 

 profound cachexia with trophic derangement (decubitus). In a 

 case of pineal carcinoma described by Hempel, there was obesity 

 during the early stages which later developed into serious fat- 

 atrophy. In a case observed by Marburg, that of a 9-year-old girl 

 with symptoms of cerebral tumour, there was extreme obesity. The 

 autopsy showed a compound tumour of the pineal gland. The 

 literature of the subject provides other instances in which pineal 

 tumour is accompanied by remarkably good nutritional conditions 

 and exceptional development of the fat-body. Genital atrophy, 

 which invariably accompanies hypophysal obesity, is absent in 

 pineal disease, and Marburg is inclined to regard pineal obesity 

 as the result of increase in the amount of the active functional 

 pineal tissue, in other words, as a manifestation of hyperpinealism. 

 This deduction is by no means conclusive, for, in the first place, 

 as Marburg himself points out, it is extremely difficult to form 

 an opinion concerning the condition of the gland ; and in the 

 second, an exceptional development of the fat-body is also 

 observed in forms of pineal disease, which both the clinical sym- 

 ptoms and the anatomical findings show to be the outcome, not 

 of an increase, but of a reduction of the active functional pineal 

 tissue. 



Of paramount interest are the observations published by 

 Ogle, Gutzeit, Oestreich-Slawyk, and more recently by v. Frankl- 

 Hochwart. In boys of under 7 years, in addition to symptoms 

 of cerebral tumour and disease of the corpora quadrigemina, these 

 authors observed abnormal growth in height, abnormal growth 

 of hair, premature development of the genital organs and of 

 sexual instinct, and mental precocity. The autopsy revealed 

 pineal tumour, generally teratoma. In these cases, the abnormal 

 growth, the premature mental and physical development, and the 

 remarkable genital hypertrophy were associated with a diminution 

 of the pineal tissue, or with what Marburg defined as dispinealism. 



These data point inevitably to the conclusion that the pineal 

 gland is an internal secretory organ which influences metabolism, 

 though the details of its functional activity are at present not 

 ascertained. Still more important is the fact that, during the 

 period of its complete development, that is to say, until the seventh 

 year, this organ exercises a definite and apparently inhibitory 

 influence upon the development of the sexual glands, and it is 



