706 ANNUAL REPORT SMITHSONIAN INSTITUTION, 19 2 8 



allowed us. Since it lay on the floor of the skull not far from the 

 root of the nose, some of the ancient writers thought that it existed 

 for the purpose of secreting mucus into the nostrils — indeed, that was 

 how it got its name; pituita, mucus, and phlegm were cognate terms 

 in the middle ages. Others, with perhaps more poetry in their 

 make-up, thought that it was the throne of the soul. 



As I have said already, one of the main avenues of approach to an 

 understanding of the internal secretions has been through a study 

 of their disorders in the human subject. The first step toward our 

 present-day conceptions of pituitary function was -made by the 

 French physician, Pierre Marie. It was he who first described a 

 condition characterized by overgrowth of the bones of the face, 

 hands, and feet. The enlargement of the facial bones was seen par- 

 ticularly in the ridges above the eyes, in the nose, and lower jaw. In 

 some cases reported by Marie this member measured 18 inches from 

 ear to ear, and the chin was some 4 inches deep. The soft tissues also 

 were thickened, the combination of fleshy and bony overgrowth pro- 

 ducing extreme coarsening of the features. This in many cases 

 amounted to grotesque ugliness. . The bones of the hands and feet, 

 especially the former, showed a similar overgrowth. This was no 

 moderate enlargement, for the hand of one of these individuals might 

 be double the size of that of a normal person of the same height. 



Marie ascribed this condition to disordered function of the pitui- 

 tary and called it acromegaly, which any Greek scholar would at 

 once tell us simply meant " big extremities." Marie thought that it 

 was the result of depression of the pituitary function, but we know 

 now that it is due to just the reverse, increased secretion by this 

 gland. The disease comes on more or less gradually, but the changed 

 facial expression is rendered very noticeable if a photograph of the 

 subject, taken perhaps 5 or 10 years previously, be compared with the 

 same person in the flesh. 



The disease, if it progresses, is invariably fatal, and in all these 

 cases an enlargement of the anterior part of the pituitary has been 

 found after death. There is no doubt then that it is this part of the 

 pituitary which is at fault. 



Sir Arthur Keith, the noted anatomist and anthropologist, has 

 thrown an interesting side light on this condition. AVhile classify- 

 ing a collection of skuljs in the museum of the Royal College of 

 Surgeons in London, he came across one that was undoubtedly 

 acromegalic. He at once recognized the prominence of the bone 

 above the eye sockets, the massiveness and elongation of the lower 

 jaw, and the general enlargement of the face area of this skull. The 

 other stigmata of acromegaly were unmistakable. But what struck 

 him most was the remarkable resemblance which this skull bore to 

 the skull of Neanderthal man — one of the earlier of the prehistoric 



