498 METABOLISM, NUTRITION, AND DIET 



In 1911 Gushing for the first time transplanted the pituitary of a child 

 into an adult man suffering from lack of pituitary secretion. A pituitary 

 cyst had been removed. The patient was temporarily but completely aroused 

 from the "profound torpor" of hypopituitarism to a temporary state of normal 

 mental and physical vigor by injections of gland extracts. After the gland 

 was grafted the extracts were ceased and the man remained in his recovered 

 state of health. 



In addition to the general nutritional improvement from the action of 

 extracts it is now known that smooth muscular tissues are stimulated, in 

 this case by posterior lobe extracts. Uterine contractions in time of atonia 

 in particular, are sharply stimulated, pituitrin producing this action strongly. 

 The reaction in the blood vessels leads to rise of blood-pressure, increase of 

 vagus tone, and augmentation of the heart beat. Pituitrin and posterior 

 lobe extracts are vigorous galactogogues. 



The feeding of extracts has been less positive, though prolonged feeding 

 has seemed to aid in preventing the symptoms of hypopituitarism in 

 alleviating obesity in particular. 



e. Acromegaly or Hyperpituitarism. Hypertrophy of the pituitary leads 

 to a great acceleration in skeletal growth or gigantism. This we have not 

 been able to prove by experimental means but must now assume to be 

 established by clinical and pathological findings. The accelerated skeletal 

 growth may occur either in childhood, youth or after full development, for 

 example, Cushing's cases numbers XXXII and I, which began to grow 

 rapidly at fifteen and twenty-five years of age respectively. 



Hyperpituitarism with its giant skeletal growth shows a tendency to pass 

 over to hypopituitarism with its attendant nutritional disorders of obesity, 

 carbohydrate tolerance, and disturbance of correlated internal secreting 

 glands and sex gonads. 



Acromegaly as such seems due to a disturbance of the pars anterior, while 

 the other nutritional derangements are attributed to disturbance of the pars 

 intermedia and pars nervosa. 



The Reproductive Glands. The ovary and the testis are undoubtedly 

 concerned with metabolism in the body. Numerous observations, not only 

 of the sex gonads but of other parts of the reproductive system, show an inti- 

 mate relation of this apparatus to the health and normal activities of other 

 parts of the body. 



a. The Testis. It has been shown repeatedly that extracts of the tissue 

 of the testis fed, or hypodermically injected when purified, increased the 

 vigor both of the muscular and of the nervous systems. Ergograms show an 

 increase in muscular power. Spermin isolated from the testis is claimed by its 

 discoverer to produce these beneficial effects. Sterilization by the removal of 

 the testis in domestic animals is followed by an entire change in the physical 

 development of the animal, especially in the so-called secondary sexual 



