PATHOLOGICAL ANATOMY OF THE HYPOPHYSIS 275 



nation of sugar, there several times occurred a slight increase in the glycosuria 

 after injection. Finally, however, it was shown that after the injection of 

 this extract there was never observed either in experiments on man or on 

 dogs, an increase of the blood sugar-contents, but on the contrary there 

 was a decrease. Borchardt saw the occurrence of glycosuria after the in- 

 jection of hypophysis extract in the rabbit. In dogs for the most part this 

 was wanting. According to our experiment I would not estimate very 

 highly the value of the evidence of the experiments on the rabbit. After 

 all that I have said thus far as to the action of the extract of the glandular 

 part of the hypophysis, it may well be assumed that the latter in some manner 

 involves the carbohydrate metabolism, not, however, by mobilizing carbo- 

 hydrates in the liver, but rather by an increase of the combustion of the 

 sugar in the periphery. With this agrees very well the decrease in the 

 blood sugar. I am fully aware, however, that this is nothing more than a 

 hypothesis. 



If we consider once more the individual physiological actions that have 

 thus far been demonstrated for the glandular or the infundibular extract of 

 the hypothesis, we readily see that they furnish very little information for 

 the pathogenesis of acromegaly. The function of the cardiovascular ap- 

 paratus is ordinarily not altered in acromegaly in a striking manner, if 

 manifestations of hyperthyrosis or hypothyrosis are not present at the same 

 time. 



Closest lies the idea that the polyuria sometimes observed may be 

 referred to a temporary irritation of the posterior lobe through the growing 

 adenoma of the anterior lobe. This conception may explain the fact that 

 such polyurias also frequently occur in tumors of the hypophysis of other 

 sorts, that are associated not with phenomena of hyperfunction of the hypo- 

 physis but on the contrary with those of insufficiency (see later). As far as 

 the genital disturbances in acromegaly are concerned, the described action 

 of the infundibular extract on the genital organs has not as yet helped to 

 make them more intelligible. In acromegaly we find, as has been stated in 

 detail before, rather an increased activity of the interstitial glands, and even- 

 tually, after transitory increase of function, setting aside of the functions 

 of the sexual glands. In hypophysial dystrophy there exists a severe dys- 

 trophy of the genital organs that includes also the interstitial glands. It is 

 therefore very much more likely that these alterations of the genital function 

 rather stand in correlation with alterations in the function of the glandular 

 hypophysis. Nothing at all is thus far known, however, as to the action of 

 the glandular extract on the sexual glands. The respiratory exchange of 

 gases does not tend to become altered in acromegaly, at least as far as there 

 exist no complications with hyperthyrosis, and in dystrophia adiposo-geni- 

 talis it is, as we shall see later, perhaps sometimes reduced. The depressor 

 action of the glandular extract and the furthering action of the infundibular 



