238 THE INTERNAL SECRETIONS 1920 



uitarism are based mainly upon the hypof unction of the 

 posterior part of the pituitary. 



The main symptoms of acromegaly, outside of the 

 excessive skeletal growth, are the enlargement of the 

 nose, lips, ears, tongue, lower jaw, hands and feet. The 

 skin appears to be coarse, rough, and thick, and often 

 has a yellowish pigmentation. The patient acquires an 

 enormous appetite bulimia and often suffers with 

 very severe headaches (the organic ' "pituitary" or 

 neighborhood pressure headaches). 



In hypopituitarism, increasing obesity is the predom- 

 inant symptom; dwarfism and infantilism, when the 

 individual is attacked in childhood. Feminism the 

 tendency in males to acquire feminine characteristics 

 as to the distribution of fat and hair, and also as to the 

 change of the voice is quite frequent; amenorrhea is 

 the rule in women, and the sexual activities are lowered. 

 Lowered temperature, low arterial tension and con- 

 tinuous drowsiness are also frequent. 



The physiological hibernation of animals and the 

 normal sleep of man may have an etiological connec- 

 tion in the temporary, suppressed activity of the pitui- 

 tary. Adolescence and puberty are very likely con- 

 trolled by hypophyseal hyperplasia. So may preg- 

 nancy, with its temporary enlargement of the lips and 

 nose, with thickening of the tissues of the hands and 

 feet, be regarded as an "actual transient acromegalic" 

 condition (19). 



THE GONADS OR ESSENTIAL SEX GLANDS 



Now, just a few words about the influence of the tes- 

 ticles and ovaries and their respective hormones. The 

 removal of the testes, or castration, produces a char- 

 acteristic symptom-complex, seen in the eunuchs, the 

 symptoms of which are described by Sajous (13) as fol- 

 lows : "A tendency to obesity of a feminine type, due to 

 slowed catabolism of fats, scantiness of hair, deficient 



