THE ANTERIOR PITUITARY AS THE ADRENAL CENTER. 



229 



twitchings of exophthalmic goiter are represented in digitalis 

 poisoning by painful contractions. In both appear the essen- 

 tially "sympathetic" or "vasomotor" phenomena, superficial 

 heat and flushings, dyspnoea, and suffocation. Even exoph- 

 thalmos is duplicated in digitalis poisoning. While prominence 

 of the eyeballs is witnessed in most grave cases, Wood 72 says: 

 "More or less exophthalmos is said to have persisted for weeks 

 in some cases." Strychnine, atropine, alcohol, opium, quinine, 

 and a few other agents more or less actively reproduce these 

 and other signs of exophthalmic goiter when administered in 

 suitable doses. But none of these give rise to cardiac symp- 

 toms similar to those of digitalis, because none possess its 

 power to safely stimulate the anterior pituitary lobe to the 

 same extent. They induce exhaustion of its cellular elements 

 before its maximum resources have been utilized: i.e., they 

 paralyze it in the midst of its functions the underlying cause 

 of suprarenal insufficiency. 



If we now group all these facts, it will become apparent 

 that seemingly irrelevant data introduced merit the title of 

 confirmatory evidence. To demonstrate that the anterior 

 pituitary body was the functional center of the adrenals a 

 direct relationship had to be shown to exist between them. We 

 ascertained that this direct connection was established through 

 sympathetic ganglia and splanchnic nerves. It then became 

 necessary to isolate the bulbo-spinal center as direct causal 

 factor in the production of certain phenomena belonging to the 

 pituitero-suprarenal domain. This was done by demonstrating 

 that structures previously shown to be governed by the ante- 

 rior pituitary i.e., the adrenals could, through their secre- 

 tion, fully sustain cardio-vascular action when all spinal con- 

 nections had been severed. The aim was not, however, to show 

 that the bulbar centers were deprived of all influence over the 

 adrenals, since we do not, as yet, know whether this is the 

 case or not, but that some of the major functions ascribed 

 indirectly or directly to the bulb cardiac action, respiration, 

 muscular activity, etc. were primarily related to the newer 

 system referred to. This was also suggested by the fact that, 



"Wood: Loc. cit., p. 310. 



