APPENDIX 315 



pressor substance, which has a marked action in maintaining 

 continuously high blood-pressure by virtue of its production 

 of peripheral vascular constriction and augmentation of the 

 force of the heart-beat. The effects of this substance upon 

 the circulation are more powerful and lasting than those of 

 suprarenal extract. Pituitary extract in addition produces 

 diuresis by a specific action on the renal epithelium, and is 

 a powerful stimulant to involuntary muscle. 



Therapeutic Uses. — Extract of the posterior lobe of the 

 pituitary body is used extensively as a stimulant to uterine 

 contractions in the second stage of labor, and is superior to 

 ergot and other oxytocics. It is very effective in cases of 

 uterine inertia, often rendering unnecessary the use of low 

 forceps, and hastens the course of labor in cases of moder- 

 ately narrow pelvis. It checks any tendency to severe post- 

 partum hemorrhage. The administration of pituitary ex- 

 tract does not suffice to induce labor or abortion. The 

 dose of the extract is 1 c.c. intramuscularly, and repeated 

 in one hour if necessary. In addition to its uses in obstetrics, 

 posterior lobe extract is administered in various conditions. 

 It is used by Cohen as a cardiovascular support in pneumonia. 

 He employs it hypodermically in doses of 1 c.c. every three 

 or four hours. Pituitary extract is said to be useful in 

 preventing abdominal distention due to temporary paralysis 

 of the bowel after abdominal operations, in surgical shock, 

 and various other conditions. 



Contra-indications. — Pituitary extract on account of its 

 marked tendency to increase blood-pressure is to be used with 

 great caution in myocarditis, arteriosclerosis and nephritis. 

 In obstetrical cases it should not be employed in abnormally 

 narrow pelvis, or in threatened rupture of the uterus. 



In cases with symptoms of glandular deficiency, such as 

 acromegaly, etc., prolonged feeding with powdered extract 



