THE PITUITARY BODY 773 



After a time the disease begins to affect the pars intermedia et nervosa, 

 and disturbances in carbohydrate metabolism come to be observed, con- 

 sisting usually in a diminished tolerance accompanied by glycosuria, in 

 the early stages of the disease, followed by increased tolerance in the 

 later stages. The glycosuria is usually accompanied by marked polyuria. 



It should be observed that sometimes tumor of the pituitary has been 

 found to exist postmortem though none of the above symptoms had been 

 recorded during life. In these cases it is probable that the disease from 

 the start had been of such a nature as to produce a tendency to hypo- 

 pituitarism rather than hyperpituitarism, for the symptoms are very like 

 those observed in animals after partial or complete removal of the gland. 

 If the condition commences before adolescence, the body fails to grow, 

 although the child may continue to increase in weight because of the 

 remarkable deposition of fat in the tissues. Sexual development is strik- 

 ingly interfered with, and the secondary sexual characteristics fail to 

 show themselves. In boys, for example, the pubic hairs fail to extend up 

 to the umbilicus; and the hairs on the chin do not develop, whereas the 

 hair of the scalp grows profusely. The bones remain of the female type, 

 and a broad pelvis, rounded limbs, small feet and hands are often ob- 

 served. In these cases there is usually excessive tolerance for carbohy- 

 drates, Avhich may explain the adiposity, sugar being converted into fat. 

 In the light of the experimental results, the effect on carbohydrate 

 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 prominent feature. Operative 

 interference in the early stages in many of these cases 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 



