64 FIELDING H. GARRISON 



tetany in some cases, but did not associate this with the para- 

 thyroid. TMe occurrence of tetany after total excision of the thyroid 

 had been a matter of ordinary observation in Billroth's clinic (1880). 

 In 1891, Eugene Gley showed that, where excision of the thyroid is nega- 

 tive in certain animals, these animals will speedily die if the four para- 

 thyroids are also removed. The physiological effects of excision of the 

 parathyroid were further investigated by Giulio Vassale and Francesco 

 Generali in 1896. In 1892, the Viennese surgeon Anton von Eiselsberg (a) 

 made a successful transplantation of the parathyroid glands from the neck 

 to the abdominal wall in a cat, and showed that tetany may be produced 

 upon its removal from this site. Subsequent experiments by H. Leischner 

 (1907) and by W. S. Halsted (a) (b) (c) at the Johns Hopkins (1909) 

 showed that the production of tetany after thyroideetomy is really due to 

 removal of the closely adjacent parathyroids, the tetania parathyropriva of 

 Erdheim. These observers found, as in Schiff's experiments, that the teta- 

 noid spasms will be abolished upon injection of an extract of the gland 

 or after parathyroid feeding or upon redrafting the gland itself. In 1908, 

 W. G. MacCallum and C. Voegtlin (a) showed, at the Johns Hopkins Hos^ 

 pital, that tetany may be abolished by treatment of the patient with calcium 

 salts. All these experiments tend to identify operative tetany with idio- 

 pathic tetany and to demonstrate the relation of both to parathyroid insuf- 

 ficiency. Another ductless gland, the pituitary body, has been shown to 

 have a marked relation to carbohydrate metabolism, and, like the supra- 

 renal and parathyroids, to be essential to the maintenance of life. 



The pituitary body, which the anatomist Sommerring called the hy- 

 pophysis cerebri (1778), was, as we have seen, regarded as an organ dis- 

 charging a mucous secretion into the nostrils, until this theory was dis- 

 proved in the seventeenth century. This structure consists of an anterior 

 glandular lobe (pars glandularis) and a smaller posterior lobe, including 

 the pars ncrvosa, or neurohypophysis, made up chiefly of neuroglia and 

 derived from the nervous system ; and of the pars intermedia of Herring, 

 a thin epithelial covering, from which pituitrin, the active principle of the 

 internal secretion of the gland is, in all probability, derived. The gland is 

 connected with the floor of the third ventricle of the brain by means of a 

 stalk or infnndibiilum. In 1838, the embryologist, H. Rathke, showed that 

 the anterior lobe is developed by the protrusion of an ectodermal pouch 

 (Rathke' s pouch) from the roof of the pharynx, and is made up of epithe- 

 lium derived from the buccal cavity. It 'lies in the embryonic rest of 

 Rathke's pouch "as a ball is held in a catcher's mitten" (Gushing). The 

 posterior lobe, made up of nervous tissue, is derived from a corresponding 

 prolongation from the anterior cerebral vesicle. Until recently the pitui- 

 tary body has been inaccessible to surgeons and to physiological experi- 

 menters, by reason of its encasement in the sella turcica of the sphenoid 

 Experimental removal of the pituitary (hypophysectomy) was 



