380 THE DISEASES OF THE SEXUAL GLANDS 



yet fully closed, the growth can proceed in fits and starts during pregnancy. 

 I shall refer to this later. 



We see therefore that in pregnancy an increase of the function of the hypo- 

 physis is associated with an increase of function of the interstitial glands, as;is 

 also the case in acromegaly. There remains only one point that also seems 

 very much to support the view of Tandler and Grosz. Tandler and Grosz con- 

 cerned themselves with the observation that the extirpation of the ovaries, 

 hence a removal of the internal secretory activity of these organs, leads to en- 

 largement of the hypophysis, and they thus regard the cause of the tall growth 

 in the castrated to an increase in the function of the hypophysis. Fischer 

 first reported that in capons and castrated male cattle the hypophysis is often 

 twice as large as in cocks and uncastrated male cattle. Moreover, Jutaka 

 Kon states that in eight castrated women the hypophysis was found enlarged 

 and rather heavy. The enlargement affected the glandular part alone and 

 on histological examination there was found the picture of true hyper- 

 trophy. Finally Tandler and Grosz several times observed a strikingly 

 large sella turcica in "skopzen." [See p. 391.] So far as the findings in the 

 hypophyses of castrated animals is concerned, there is found, however, the 

 statement that manifestations of an apparently degenerative kind (vacuole 

 formation) are often observed. I am very sceptical with regard to the finding 

 of Jutaka Kon. At least one cannot draw from it the inference as to an in- 

 crease of function of the hypophysis, for nobody would state that symptoms 

 occur in castrated women that indicate such an increase. In male late 

 castrates may be observed such an enlargement of the sella turcica, as in one 

 of the cases I reported (castration in the twenty-sixth year of life) , or in the 

 case of Rieger (epistolatory communication). Further Tandler and Grosz 

 have already stated that no enlargement of the sella was found, and further 

 on I shall report four cases of eunuchoidism, in which the sella was found to 

 be normal in size or strikingly small. Finally as far as the tallness of enunchs 

 and eunuchoids is concerned, I would refer it not to an increase in function 

 of the hypophysis, but to a persistence of the epiphysial junctures. As 

 we have seen in the chapter on the hypophysis early acromegaly does not 

 always lead to tallness, also not when the epiphysial junctures have not 

 closed prematurely. Nor are there to be found in eunuchs or in eunuchoids 

 any other signs of a hyperfunction or an increased function of the hypo- 

 physis; I call to mind only the so characteristic behavior of the carbohydrate 

 metabolism in acromegaly. The view of Launois and Roy that when the 

 epiphysial junctures are open, functional increase of the hypophysis leads 

 to tallness or to gigantism, and when closed, to acromegaly is to my mind as 

 untenable as the opinion that falling away of the sexual glands produces in- 

 crease of function of the hypophysis. If we follow both views to their ulti- 

 mate consequences, we arrive at the postulate that castration after 

 epiphysial closure must call forth acromegalic manifestations, as is evidently 



