HISTORY OF ENDOCRINE DOCTRINE 



65 



essayed by Sir Victor Horsley (&) (1886), Marinesco (1892), Vassale and 

 Secchi (1892-94), Gatta (1896), Biedl (1897), von Cyon (1898-1900), 

 and others, with negative or contradictory findings, resulting, no doubt, 

 from the difficulties encountered in approaching the gland through the skull 

 and of insuring its entire removal under these conditions. In 1908, an im- 

 portant advance was made by Nicholas Paulesco, of Bucharest, who devised 

 an operation by the temporal route and showed that the pituitary body is 

 essential to life, its removal being fatal to the animal. At the same time 

 he found that removal of the anterior lobe is equivalent to entire removal 

 and that excision of the poste- 

 rior lobe is negative. Paulesco's 

 experiments were put to the test 

 by Harvey Cushing and his as- 

 sociates at the Johns Hopkins 

 Hospital, their experiments be- 

 ing performed mainly upon 

 dogs. They found that total 

 removal or removal of the an- 

 terior lobe alone are alike fatal, 

 the animal dying in three days 

 with a peculiar train of symp- 

 toms consisting of lowered tem- 

 perature and blood pressure, 

 sluggishness, unsteady gait, 

 rapid emaciation, slowing of 

 pulse and respiration, diarrhea,, 

 diminished urine in adults, 

 polyuria and glycosuria in pup* 

 pies. Partial removal of the an- 

 terior lobe in normal dogs was 

 found to produce a pronounced 

 state of obesity, with a remark- 

 able shrinkage of the external (male) genitalia. In other words, Cushing 

 produced, by experiment, a genuine pathological reversion to the condition 

 known as obesity with genital infantilism, hypopituitarism, or "dystrophia 

 adiposogenitalis," described by Alfred Frohlich in 1901. The neighbor- 

 hood symptoms in this condition, referred to the eye, were later described 

 by Cushing (a) in 1906. In the case of the posterior lobe, which, as shown 

 by Cushing and Goetsch, discharges its secretion into the cerebrospinal 

 fluid, partial removal or the production of insufficiency of the secretion by 

 putting a clip upon the stalk of the gland produces, at first, a temporary 

 lowering of the animal's assimilation limit for sugars, followed by a marked 

 and permanent increase in its tolerance for carbohydrates, which is again 

 promptly lowered by injection of an extract of the posterior lobe. In 1895, 



Fig. 12. Alfred Frohlich 



