708 ANNUAL REPORT SMITHSONIAN INSTITUTION, 1928 



of pituitary giantism. The giants are usually the children of nor- 

 mal parents and they themselves have normal children. 



The pituitary by these excesses, acromegaly and gigantism, has 

 revealed itself. There is every reason to believe that its physiological 

 function is to urge the growing bone within normal limits. 



If the pituitary can increase its output above the normal and pro- 

 duce giants, the question naturally arises whether it ever fails to 

 manufacture enough of its hormone and produce dwarfs. It does, 

 and there are two kinds of dwarf which may result from a deficient 

 pituitary secretion. Only one of these is caused by deficiency of the 

 anterior lobe alone. He resembles the midget, but differs in certain 

 essential features from that popular attraction of the side shows. 

 The midget remains unexplained; he may be a pituitary case, but 

 there is no evidence that he is. The true anterior lobe dwarf is a 

 rather quaint little person. He (or she) is perfectly proportioned, 

 delicately formed, and usually of a pleasing appearance. To the 

 casual observer he appears normal in every way except in size, and 

 his intelligence is usually of the average grade, though in some cases 

 it is below the normal. They are men and women in miniature — 

 adult figures, seen as it were through the wrong end of the telescope, 

 for their bodies are never proportioned upon the plan of the child, 

 that is, with relatively large heads. Nor are their facial features 

 childlike. 



Very frequently the posterior lobe as well as the anterior is defi- 

 cient. The disorder then is one of the pituitary as a whole. There 

 will be seen a combination, a mixture of effects, some caused by one 

 lobe, some by the other. 



Before these combined effects can be described the functions of the 

 posterior lobe must be outlined. The duties of this part of the gland 

 are not so clear as those of the anterior. True, an extract may be 

 obtained from it which produces immediate and very definite effects 

 when injected into an animal. It causes, for instance, a rise in the 

 blood pressure and induces contractions of the muscular walls of 

 various organs of the body. But whether they are part of a true 

 physiological function or merely effects produced through artificial 

 methods of extraction can not be said. 



There is no evidence that the posterior lobe is concerned in any 

 way with the development and growth of the bones. There is one 

 function, however, of which there seems to be no doubt. It is con- 

 cerned with the disposal of sugar by the body. When its secretion 

 is produced in insufficient amount, there is a remarkable increase in 

 the quantity of sugar which the body can use. If a normal person 

 takes a large quantity of sugar, it is not all utilized by the body cells. 

 The excess can be found in the blood and is later excreted. The 

 subject of posterior-lobe deficiency can utilize several times that 



