218 CORTEX 



anterior pituitary hormones in the two diseases. The few pre- 

 liminary reports which have been made on the results of such 

 studies may be ignored since they were based on the use of 

 extracts the hormone content of which was negligible and in- 

 volved only a short period of clinical observation with no 

 subsequent verification of the diagnosis or the effect of with- 

 drawing the extracts. 



It should be emphasized, however, that although secondary 

 pituitary insufficiency may be expected to occur in Addison's 

 disease (as is borne out by anatomical findings) the chief symp- 

 toms are certainly not attributable to hypophyseal dysfunction 

 but resemble those observed in acute experimental adrenal 

 insufficiency. The infantilism observed in Addison's disease 

 when it occurs in children and the progeria which has been 

 found to accompany sclerosis of the adrenals are probably due 

 to pituitary insufficiency. 



As stated above, the injection of alkaline extracts of the 

 pituitary causes hypertrophy of the adrenals and prevents the 

 atrophy which follows hypophysectomy. The tendency to as- 

 cribe all effects which follow injections of pituitary extracts to 

 an hypothetical new "hormone" has resulted in the assumption 

 that the above described effects on the adrenal cortex are due 

 to an "adrenotropic hormone" 185 which normally regulates the 

 adrenal. Scrutiny of the experimental data, upon which the 

 assumed existence of this hormone is based, does not, however, 

 inspire confidence. The available extracts derived from the 

 hypophysis are at their best relatively crude concoctions. The 

 adrenals, moreover, are extremely sensitive and readily respond 

 by hypertrophy to the injection of foreign materials into the 

 organism. Hence one might justifiably doubt that the adrenal 

 hypertrophy observed after injection of the so-called adreno- 

 tropic hormone is the result of specific stimulation by a hor- 

 monal entity. The so-called thyrotropic hormone of the pitui- 

 tary also causes hypertrophy of the adrenals. This action is 

 mediated by the thyroids for it fails to occur in thyroidecto- 



