" GIANT GROWTH " OF TISSUES 341 



a " true " or autonomous tumour our stereotyped conception 

 of such is that it originates as a circumscribed overgrowth of cell 

 elements, not exercising any function of service to the body, or 

 at least becoming separate from the normal tissues in its physio- 

 logical and functional relationships. Even if we cannot with 

 Cohnheim regard it as derived always from a matrix of super- 

 abundant or erratic deposit of embryonic elements, we all, I 

 think, are accustomed to accept Ribbert's view that it is self- 

 confined, dependent upon the organism for its nourishment, but 

 otherwise largely if not quite independent. That is our stereo- 

 typed mental picture of what constitutes the tumour proper. 



Let me approach my subject from what may appear to be a 

 novel, but what I believe to be the correct, standpoint. 



The researches upon the functions of ductless glands pursued 

 with increasing activity during the last twenty years have 

 demonstrated in a wholly unexpected manner that sundry of 

 these glands have a remarkable influence over the growth of 

 particular tissues. This is now so well recognized that it is 

 needless for me here to give a detailed statement. Briefly, the 

 outstanding results are these : 



1. That specific ductless glands and their internal secretions 

 influence the growth, not of all tissues equally, but of particular 

 tissues. Thus the experimental removal of the whole of the 

 anterior portion of the pituitary is associated with defective 

 growth of the bones, whereas, per contra, excessive development 

 of the anterior portion of the same gland is associated with 

 excessive growth of bone. Overgrowth of the adrenal cortex 

 is more particularly associated with premature development 

 and overgrowth of the organs of generation. Hypoplasia of the 

 thyroid is associated more particularly with overgrowth of the 

 subcutaneous connective tissue ; hypopituitarism with localized 

 or generalized adiposity along with genital deficiency. 



2. Such overgrowth or arrest of growth of particular tissues 

 may have associated with it a coincident overgrowth of asso- 

 ciated tissues and parts. In osseous giantism associated with 

 excessive development of the anterior portion of the pituitary 

 we find coincident increased development of surrounding tissues ; 

 along with the premature development of the essential organs 

 of generation seen to accompany benign adenomatous tumours 

 of the adrenal cortex we note an over-development of the second- 



