77//'; ini'OI'/lYSI.S AM) ACROMEGALY 021 



tested by the low blood pressure and Kt^ni^i'^il l^^v tone of the unstri- 

 ated muscle tissue. Carbohydrate metabolism is also altered, Porges"'^ 

 having found hypogluccmia in Addison's disease;, and an increased 

 sugar tolerance having been observed by others. Whether the ad- 

 renals exert a deto.xicating effect, and the symptoms of the disease 

 are partly the result of an autointoxication of some sort, is at present 

 unknown, although this idea has often been advanced. The general 

 metabolism of Addison's disease shows no very striking or character- 

 istic changes, over and above those associated with the emaciation. 

 Wolf and Thacher^'* found a decrease in endogenous creatine and 

 purine excretion, and some evidences of acidosis towards the end of 

 the disease; deaminizing power and oxidation of cystine sulphur to 

 SO4 were not impaired. Eiselt believes that there is a toxicogenic 

 loss of tissue. 



Administration of adrenal tissue and extracts, or epinephrine, 

 whether by mouth or subcutaneously, is not effective m ameliorating 

 the course of Addison's disease, at least in most cases. Thus, in 97 

 cases collected bj'' Adams, ^^ adrenal treatment caused some improve- 

 ment in 31, 43 were not benefited, 7 were made worse, while 16 

 were described as permanently improved. The most favorably 

 affected is usually the muscular and gastro-intestinal asthenia, while 

 the pigmentation is not usually altered. There is little effect on 

 metabolism. ^^ 



The Hypophysis and Acromegaly's 



Although the hj^pophysis contains in its anterior lobe and in the 

 pars intermedia, a certain number of spaces filled with colloid and re- 

 sembling the alveoli of the thyroid in appearance, ^^ there is no evidence 

 that an appreciable amount of iodin is present here except when thera- 

 peutically administered.^^ The posterior lobe contains an active diu- 

 retic and pressor substance, ^^ the exact nature of which is not yet 

 known, although in many respects its action resembles that of epi- 

 nephrine. It seems less active in producing arteriosclerosis than is epi- 

 nephrine, and its pressor effects are of longer duration. It seems to 

 stimulate smooth muscle without respect to innervation (thus differing 



82 Zeit. klin. Med., 1909 (69), 341; also Bernstein, Berl. klin. Woch., 1911 (48), 

 1794. Normal blood sugar was found by Broekmeyer, Deut. med. Woch., 1914 

 (40), 1562. 



83 Arch. Int. Med., 1909 (3), 438. 

 8* Practitioner, 1903 (71), 472. 



85 Beutenmliller and Stoltzenbergcr, Biochem. Zeit., 1910 (28), 138. 



8« Full bibliography in the monograph by Harvey Gushing, "The Pituitary 

 Body and its Disorders," Philadelphia, 1912; also .\schner, Pfluger's Arch., 1912 

 (146), 1. ^ o 



87 Composition of hypophysis given bv MacArthur, Jour. Amer. Chem. Soc, 

 1919 (41), 1225. 



88 Wells, Jour. Biol. Chem., 1910 (7), 259. 



89 Lewis, Miller and Matthews, Arch. Int. Med., 1911 (7), 785; Herring, Quart. 

 Jour. Exp. Physiol., 1914 (8), 245 and 267. 



