RELATIONS OF ANTERIOR AND POSTERIOR PITUITARY. 207 



normal, mere overgrowth; the second pathological, the former 

 predisposing to the latter, prevails, true gigantism (not the 

 mere overgrowth of very tall subjects) is probably rare without 

 acrornegaly. Marie's view that "gigantism is acromegaly of 

 the adolescent," while "acromegaly is gigantism of the adult" 

 probably comes nearer the actual condition present in both 

 forms. This is suggested by the fact that, if the pituitary does 

 succeed to some of the functions of the thymus and the latter 

 persists sufficiently long to add materially to the stimulating 

 effects of the former upon the adrenals, a vicious circle of 

 overnutrition is formed through which the longevity of the 

 thymus is prolonged and sustained until softening, fatty de- 

 generation, or fibrosis i.e., insufficiency of either of the three 

 sets of organs initiates the cachectic stage. This is clearly 

 indicated by the terminal symptoms that attend cases of true 

 gigantism. "'Myth and popular impression to the contrary," 

 says Woods Hutchinson, 43 "giants are a short-lived, feeble- 

 minded, weak-bodied race." This nevertheless leaves us free 

 to distinguish at least three main forms of acromegaly from the 

 standpoint of pathogenesis: 



1. A form due to overnutrition of predisposed pituitary 

 through continuous overactivity of the adrenals, maintained, in 

 turn, by a chronic toxaemia. 



2. A form due to persistence of the thymus and brought on 

 by over stimulation of the adrenals by the phosphorus-containing 

 thymic secretion, resulting in overnutrition and hypertrophy of 

 the pituitary. 



3. A form due to morbid processes tumors, etc. in the 

 pituitary itself. 



THE FUNCTIONAL RELATIONS BETWEEN THE ANTERIOR 

 AND POSTERIOR PITUITARY BODIES. 



We have seen the remarkable observations of Bourneville 

 and Katz in respect to the absence of the thymus in idiots. 

 If we couple this feature with the clinical evidence attesting 

 that the pituitary gland is the growth-center of the organism, 

 we can analyze and perhaps find the connection between these 

 organs and between the two pituitary lobes. 



43 Woods Hutchinson: Quoted by Hinsdale, Joe. cit. 



