Effects of Kemoval of Pituitary 101 



post-mortem, and they attribute the survival to such a remnant. On the 

 other hand, they obtained no definitely recognisable symptoms by severance 

 of the infundibular stalk, a procedure which, as we have seen, Paulesco 

 alleged to be fatal. Removal of part only of the anterior lobe leads to 

 certain definite changes in metabolism, which are considered by Cushing 

 to be due to deficient secretion, a condition to which he has given the name 

 hypopituitarism. Similar results to those of Paulesco and Cushing have 

 been obtained by Biedl, and recently by Ascoli and Legnani. 



The symptoms of complete removal or apituitarisin (cachexia hypo- 

 physeopriva) are described by Cushing as follows : " On the day after the i^ 

 operation the animal (dog) usually appears normal, with fair appetite and 

 no characteristic signs of loss of secretion. Gradually it becomes lethargic, 

 refuses food and responds slowly or not at all to the voice. Later the 

 respiration becomes slow and the pulse both slow and feeble, the musculature 

 limp, often with tremors and fibrillar twitching ; the back is arched, and 

 the temperature subnormal ; finally, often within forty-eight hours, the 

 animal becomes comatose and dies in this condition." According to Cushing, 

 immediate reimplantation of the removed gland in some other structure 

 causes an abatement of the symptoms and prolongs life ; but whether in- 

 definitely or not is uncertain, and would doubtless depend upon whether the 

 graft underwent subsequent degeneration. In Cushing's later experiments 

 extirpation of the gland seems to have been less certainly fatal or longer 

 delayed, the animals exhibiting the symptoms rather of hypo- than of 

 a-pituitarism. This may be due to small portions of the gland having 

 been left behind, or to the employment of younger animals, or to the 

 vicarious activity of some other organ or organs. The fact is interesting 

 because Aschner, who has performed a large number of extirpations mainly 

 by the inferior operation (through the base of the skull), has not found the 

 gland to be essential to life — or at least has obtained very considerable 

 prolongation of life after its entire removal. It must, however, be regarded 

 as doubtful if it is possible to effect complete removal by this operation. 

 Aschner himself, who admits the difficulty, regards the small residue as 

 unimportant. In all his cases symptoms of hypopituitarism showed them- t, 

 selves. His animals, if young, remained small : their milk teeth were 

 retained and also their lanugo hair: their epiphyses did not ankylose. 

 The thyroid was enlarged, the thymus persistent, and the cortex of the 

 suprarenal thickened. The development of the sexual organs was markedly 

 retarded. The animals laid on fat. In the adult the chief effect of the 

 removal was the putting on of fat. The secretion of carbonic acid was 

 found by Benedict and Homans to be diminished. In pregnant animals 

 Aschner found removal of the pituitary to be always followed by abortion. 



The experiments of others have yielded different results. Thus Horsley 

 and Handelsmann, who attempted complete extirpation in a number of 

 animals, chiefly by the operation through the base of the skull, state that 

 although a large proportion of their cases died within forty-eight hours, 



