JOHN T. HALSEY 



(1) that symptoms due to dysfunction of the pituitary (damaged by the 

 thyrotoxicosis) are benefited by the pituitary administered; (2) that the 

 results are due to the beneficial effect on the ovarian functions, which 

 are so commonly deranged in this disease; (3) that, as claimed by Pal^the 

 pituitary exerts a restraining influence on the abnormal thyroid activity; 

 (4) that the relief of at least some of the symptoms is due to purely 

 pharmacodynamic actions of the posterior pituitary extract. 



This method of treatment appears worthy of trial in inoperative 

 cases of exophthalmic goiter, especially in patients in whom the menstrual 

 function is deranged. 



It is quite in accord with the present uncertain status of organo- 

 therapy that similar favorable effects have been reported as following the 

 administration of anterior pituitary substance (Harrower (6) (1917), 

 Iloppe (), Richter). Inasmuch as experimental evidence is fairly con- 

 clusive to the effect that the anterior pituitary and the thyroid are closely 

 related physiologically and that they can to some extent at least function 

 vicariously, it is hard to believe that administration of one of these glands 

 can exert a favorable influence on a condition caused largely (if not en- 

 tirely) by overactivity of the other. 



Hypophyseal Hormonotherapy 



The powerful pharmacodynamic actions exerted by posterior pituitary 

 substance on various functions have led to its trial in a large number of 

 conditions; in some of which it has failed completely, while in others its 

 value has been clearly demonstrated, and in still others is not yet 

 determined. 



Disorders of the Circulation. The striking effects of posterior pitui- 

 tary substance on the circulation, as observed in the laboratory, naturally 

 led to its early and wide trial in this field. 



In cardiac diseases, both acute and chronic, it has been used by many 

 authors, Imt there is much difference in their conclusions as to its value. 

 Rcimn and Delille reported that both oral and hypodermic administration 

 of extracts of the anterior ( ! ?) and posterior portions exerted a favorable 

 influence in various types of cardiac diseases, especially in cases of myo- 

 carditis.- 1 ' They report as evidence of its favorable influence in these 

 cases increased diuresis and slightly increased blood-pressure. 



Arrhythmias were not influenced, but in several cases tachycardia 



"Laboratory studies appear to have proved definitely that the anterior portion of 



the gland contains no substance which could act beneficially on the circulation. This 



claim of these authors that anterior pituitary substance can produce such effects in 



inn- must therefore he received very skeptically; and at the same time it raises 



t as to the reliability of their conclusions concerning the value of the admin- 



>n of extracts of the posterior lobe. Moreover, it has been the almost universal 



it posterior pituitary substance administered orally is inert or nearly so. 



