616 CHEMICAL PATHOLOGY OF THE DLCTLE^^ GLAyOfi 



carry on tlie functions of the tissue in which they arise. Acromegaly 

 without hypoi)hyseal changes is rare, especially if we consider the 

 liner cytological evidence of cellular activity/- So far, little of chem- 

 ical interest has been learned concerning this disease. The metabo- 

 lism studies generally indicate a retention of nitrogen, phosphorus and 

 calcium, because of the overgrowth of bone and soft tissues.^--' Ac- 

 cording to some observers this retention is decreased, or changed to an 

 excess elimination, by administration of hypophyseal substance. ^^ The 

 elimination of endogenous uric acid is said to be greatlj^ increased 

 in acromegaly, and decreased in eases with hypofunction of the 

 gland. ^* A considerable excretion of creatine was 'observed by 

 Ellis.-'-^ 



Glycosuria and actual diabetes is frequently present in acromegaly 

 (40 per cent, of the cases collected by Borchardt),*" presumably from 

 interference with the regulating function of the hypophysis, but this 

 assumption has been questioned because of the fact that lesions in 

 this location might also produce glycosuria by affecting the "diabetic 

 center." However, since puncture of the hypophysis causes glyco- 

 suria, while injection of posterior lobe extract produces glycosuria 

 dependent upon hyperglycemia (Gushing), and in view of the fact 

 brought out by Borchardt that in cases of tumor of the hy})ophysis 

 without acromegaly, glycosuria has never been observed, there is 

 much probability that in many if not all of the cases of glycosuria with 

 acromegaly, it is the liypophysis itself that is concerned, and that both 

 the acromegaly and the glycosuria are caused by hyperactivity of the 

 gland. 



In later stages of acromegaly there may develop a hypoactivity 

 because of pressure upon the posterior lobe or infundibular stalk, 

 whereupon the sugar disappears and is replaced by an increased toler- 

 ance for sugar.^^ 



THYMUS-': AND OTHER DUCTLESS GLANDS 



From the clicrnical stand|)()iiit little of iiiterost is known coneerning this orpan. 

 Tt is frequently used as a souree of nucleic acids, in which it is rich, but there 

 is no study of its clieniical clianges tliat is of interest in i>atholoufy. l-Alirpation 

 of the thymus in youiii;' animals is followed by marked defects in tlie (le\('loi)inent 

 of the skeleton, and changes in tlie development of the sex organs.-''" Some au- 

 thors state that thymus extirpation causes a loss of calcium, and tlial a calciinn 



42 See Lewis, 'Bull. Johns Hopkins' TTosp.. 1005 (16), InT. 



42;i See Hergeim, Stewart and lii'wk. Jour. Exp. ^led., ini4 (20). 21S. 



4^ See Kidiinraiit, Dissert., Zuricl', (Jebr. l.ceman, 1012: Mediureccanu and 

 Kristeller, .Tour. Biol, ("hem., 101 1 ( !) ) , 100. 



■"Falta and Nowaczynski, Berl. klin. Woch.. 1012 (40), ITSl. 



■'•"'Jour. Amer. Med. Assoc. 1011 (5(>), 1S70. 



••« Zeit. klin. Med., lOOS (fifi), X\2. 



••7 Full discussion in .Johns Hopkins TIosp. Bull., 1011 (22). M\'->: 101:? (24), 40. 



2" In addition to Biedl's "Innere Sekretion." see Wiesel, Krgebnisse Plnsiol., 

 1011 (XV (,) ), 41(>: Klose and Vogt, Beitr. z. klin. Chir., lOlO ((10), 1; Matti, 

 .Mitt. (Jrenz. .Med. u. Chir.. 1012 (24), H. 4-5. 



2"ia Not corroborated iiv Taiipcnlieimer (.Tour. Kx]). Med.. 1014 (10). :nO; (20), 

 477) or by Nordmann, (Ardi. klin. Ciiir.. 1014 (KH!), 172). 



