PHYSIOLOGY OF THE POSTERIOR PITUITARY. 511 



The posterior pituitary lody is the general center of the or- 

 ganism from which all the nervous energy transmitted by the ~bulbar 

 centers arises. 



All the above evidence and the various facts that we have 

 not included in the summary which sustain the conclusion just 

 submitted being of a physiological kind, it seems evident that 

 we should, in view of the important functions ascribed to the 

 organ, also be able to adduce clinical evidence. It is perhaps 

 needless to say that the testimony available can only be in- 

 direct, the prevailing belief that the organ is not endowed with 

 physiological functions having kept it out, as it were, of the 

 clinical field. And yet if it holds the important relation to 

 the nervous system we believe it does, its influence in the 

 pathogenesis of general neuroses must be very great. No dis- 

 ease having so far been associated with this lobe, our only hope 

 lies in our being able to discern among the symptoms of typical 

 disease of the anterior lobe what signs might be assigned to 

 implication of the posterior, with which it is intimately blended. 



It is interesting to note, in this connection, that quite a 

 number of exceptionally able clinicians von Recklinghausen, 

 for instance have considered acromegaly as a trophic neuro- 

 sis, the organic disease of the pituitary being considered by 

 them as secondary. Again, the neural canal of lower forms 

 led Collina 15 to suggest that the hypophysis (as a whole) also 

 produced a fluid capable of nourishing nervous elements and 

 that deficiency of this fluid, by reducing the activity of the nu- 

 tritional processes, gave rise to acromegaly: further evidence 

 that the tie between the nervous system and these organs is 

 sufficiently marked clinically to have attracted considerable at- 

 tention. That the various theories adduced also bear upon 

 nutrition of the nervous elements is significant as testimony in 

 favor of our view. Indeed, the clinical signs that point to 

 impaired nervous action are numerous, and are present in 

 practically all cases of acromegaly when the anterior lobe has 

 become sufficiently enlarged or functionally disordered to in- 

 volve the posterior lobe, either directly by pressure, continuity 

 of tissue, etc., or indirectly by overstimulating the adrenals, or, 



"Collina: Gazzetta degli Osped., Jan. 8, 1899. 



