316 THE DISEASES OF THE HYPOPHYSIS 



adynamia, crying-out of the animals under experimentation, tonic and clonic 

 convulsions and death). On the contrary when the hypophysis is removed 

 without injury to the hypophysial peduncle, the manifestations detailed re- 

 main absent, the animals are again lively a few hours after the operation, and 

 remain alive. There develops, especially in youthful animals a condition 

 that in the most important features simulates hypophysial dystrophia 

 adiposo-genitalis. The animals become fat, they remain appreciably be- 

 hind in development, the dentition and the ossification are markedly delayed, 

 the epiphysial junctures can remain open for a long while, the childish 

 proportions are retained, and the epidermoidal structures, such as the 

 hairs and claws, show developmental disturbances. The genitalia remain 

 markedly infantile, spermatogenesis is extremely sparse, the sexual instinct 

 is markedly reduced, in female animals rut is weakened and never is there 

 pregnancy. Investigations as to the metabolism of such animals shows that 

 there is great similarity with alterations that Eppinger, Rudinger, and 7 

 found in animals without thyroids. The fasting protein exchange is 

 markedly reduced. The glycosuric action of adrenalin is reduced, and is 

 associated with a slowing of the pulse and of breathing, reduction of the 

 body temperature, and an appreciable reduction of caloric production. 

 Benedict and Romans have demonstrated the reduction in the carbonic acid 

 production, Aschner and Forges the reduction of oxygen consumption, in 

 such animals. The alterations described must be referred to the extirpation 

 of the glandular hypophysis, as extirpation of the posterior lobe alone calls 

 forth no essential alteration. The traces of the epithelial seam of the inter- 

 media that must remain behind in the hypophysial peduncle do not, as 

 Aschner supposes, come into consideration. 



It is perhaps hardly necessary to describe in detail the great similarity 

 of this symptom complex produced by extirpation of the hypophysial appa- 

 ratus with that of hypophysial dystrophy. In spite of this I must enter 

 into a discussion of the individual symptoms and their relation to the hy- 

 pophysis, as just on this point the opinions differ from each other consider- 

 ably. In this discussion we shall have to keep our attention directed to the 

 fact that, as in acromegaly, the cardinal symptoms due to the deficiency of 

 function of the hypophysis (in acromegaly, the excess of hypophysis function) 

 must be kept separated from the symptoms that are due to the pressure of 

 the growing tumor on the neighboring organs or due to the associated disease 

 of other ductless glands. 



To-day the view of most authors is that hypophysial dystrophy with 

 both of these cardinal symptoms the genital disturbances and the obesity 

 depends on a loss or diminution of function of the hypophysis (v. Noorden, 

 Fettsucht [Obesity] 2nd edition). The relation of both these symptoms to 

 the hypophysis has, however, been called into question. Erdheim assumed 

 that the tumor on growing out from the sella actuated an as yet unknown 



