818 THE ENDOCRINE ORGANS, OR DUCTLESS GLANDS 



metabolism may be explained as due to involvement of the posterior 

 lobe. Mental development is retarded, and psychic derangements are 

 sometimes observed. 



Where the hypopituitarism does not develop until after adolescence, 

 some of the above symptoms will of course be missed, but many will be 

 observed, such as dryness of the skin, loss of hair, and the tendency in 

 the male to adopt certain of the female characteristics, particularly with 

 regard to the growth of hair. Obesity and increased tolerance for sugar 

 are also evident, and pigmentation of the skin, something like that of 

 Addison's disease, is said often to be a p-rominent feature. These clinical 

 types of hypopituitarism (both the preadolescent and the postadolescent) 

 were first described as entities by Frohlich, and are grouped under the 

 term dystrophia adiposo-genitalis. They are due undoubtedly to involve- 

 ment of both lobes of the pituitary. 



In contrast to the foregoing, a form of infantilism associated with hypopi- 

 tuitarism occurs, in which the subjects are not obese but rather the reverse. 

 There is a markedly retarded development of the skeleton and the sexual 

 organs, while the patient presents to the casual observer the appearance 

 of an ill-nourished child. When stripped, however, it is seen that he or 

 she, is in reality, except for the sexual immaturity, a man or a woman in 

 miniature. The form possesses the lineaments of the adult, the relative 

 bodily proportions of the child being absent. This type, which is usually 

 known as that of Lorain, is probably due to disease affecting chiefly the 

 anterior lobe. Operative interference in the early stages in many cases 

 of hypopituitarism as well as of hyperpituitarism is of undoubted benefit, 

 as is shown by the brilliant work of Harvey Gushing, to which the reader is 

 referred for further information. 



The Relationship of the Pituitary Gland with Other Endocrine 



Organs 



The relationship of the pituitary gland with other endocrine organs 

 seems to be an intimate one. 



1. With the Thyroid and Parathyroid Glands. That enlargement of 

 the pituitary occurs after thyroidectomy in man has been known for a 

 considerable number of years. The enlargement affects more particu- 

 larly the pars anterior, although changes are also described in the pars 

 intermedia et nervosa. Accompanying the enlargement of the anterior 

 lobe, vesicles containing colloid-like material often become developed in 

 it, but even after the hypertrophy has proceeded to a considerable de- 

 gree, this colloid does not contain iodine, nor does an extract have the 

 same physiological effect as one of the thyroid gland. It can not replace 

 thyroid extract in the treatment of patients with goiter or myxedema, 



