THE ESSENTIAL DUCTLESS GLANDS 237 



one of the most valuable things in the human body. It 

 is indeed very small in size, less than one gram in 

 weight, and apparently somewhat heavier in females, 

 especially during pregnancy. Like most precious jew- 

 els it is hidden away in the intracranial locker of the 

 body, where, secure from outside attack, it sets rough- 

 rider-like, in the saddle (sella turcica) and through 

 the innumerable hormonic reins that connect it with 

 the other endocrine glands, exerts a most powerful in- 

 fluence over the whole organism. 



It is composed of two parts, the anterior and pos- 

 terior lobes, whose active principles differ considerably 

 from each other. As with all the other ductless glands, 

 there are two conditions of dysfunction to be consid- 

 ered the overactivity of the gland, or hyperpituitar- 

 ism ; and its lowered or lessened activity hypopituitar- 

 ism. Of course, due to the different physiological char- 

 acteristics and relationships of the anterior and pos- 

 terior lobes of the gland, there is some confusion yet 

 as to the source of symptoms produced, though the 

 work of Engelbach, of St. Louis, has clarified the 

 matter. 



As a type of hyperpituitarism, we will consider the 

 disease known in childhood as gigantism, and in adults 

 as acromegaly, or Marie's Disease, Marie (9) having 

 been the first (in 1886) to give a full description of it. 



Gigantism, or the excessive growth of the skeletal 

 bones, results when hyperpituitarism occurs in a period 

 before the epiphyses have joined, while acromegaly is 

 the result of the same conditions occurring in the sub- 

 sequent period of adolescent life, or to be more correct, 

 gigantism may be regarded as the prodromic stage 

 of acromegaly (10). It is possible, as Gushing (1) 

 thinks, that the hyperfunctional symptoms in acrome- 

 galy are due to the hyperactivity of the anterior part of 

 the pituitary, while the symptoms ascribed to hypopit- 



