190 THE PITUITARY, THYROID AND ADRENALS AS A SYSTEM. 



that of insufficiency. We are brought back to the similarity 

 of these symptoms to some of those observed in exophthalmic 

 goiter, the specific signs of the latter being the missing ones. 

 Why should the latter the intense tissue-waste, the rapid 

 heart-action of the first stage be peculiar to Graves's disease? 

 There seems to be good ground for the belief that they repre- 

 sent the highest expressions of suprarenal activity, especially 

 the cramped heart: a fact easily accounted for by the phys- 

 iological nature of the stimulant, the only truly physiological 

 stimulant so far met with in our inquiry. In thymus we found 

 a product connected with bone- and nerve- nutrition, but 

 capable of incidentally stimulating the adrenals. Have we in 

 the pituitary another physiological stimulant, as in the thy- 

 roid, or an indirect stimulant, as in the thymus? 



The experiments of Vassale and Sacchi will assist us in 

 clearing this question. Again do we meet with death as the 

 result of removal of the organ; it also followed, we have seen, 

 removal of the thyroid and the thymus. This brings the prob- 

 lem to the common plane of suprarenal insufficiency, if the 

 symptoms are similar to those observed after removal of the 

 other glands. Rigidity of gait, fibrillary contractions, and 

 spasms, followed by anorexia, depression, and hypothermia, 

 point to the two familiar stages, however, and surest that 

 removal of the pituitary is followed by the accumulation of 

 poisons in the organism which it is the organ's function to 

 destroy: a theory which many investigators have advanced. 

 But if they ascribe to the pituitary the role of a laboratory for 

 the destruction of toxics, restoration of the laboratory to its 

 normal functions should alone insure continuation of the 

 prophylactic process; and the injection of a small quantity of 

 the glandular extractive should not suffice to temporarily elim- 

 inate the morbid symptoms unless that extractive stimulate 

 some other organ in the body capable of carrying on the proph- 

 ylactic function. Vassale and Sacchi have not only obtained 

 restoration by this means, but the many experiments just re- 

 ferred to have demonstrated that pituitary extract was essen- 

 tially a blood-pressure-raising substance which, in the light 

 of our work, means a powerful suprarenal stimulant. 



This feature completely transforms the question. Indeed, 



