724 DEAN LEWIS 



atrophic, the hair fell out, the epiphyseal cartilages persisted, spermato- 

 genesis ceased in the male and regressive changes occurred in the ovarian 

 follicles in'the female. These are much the same changes described by 

 Gushing in the animals in which partial removal of the anterior lobe had 

 been performed corresponding to the changes of dystrophia adiposo- 

 genitalis as observed in man. 



There is no doubt that the hypophysis can be removed by the buc- 

 cal route with less injury to the brain than through the temporal 

 route, but infection occurs more frequently when the buccal route is 

 employed. It is surprising, however, how infrequently infections occur 

 even when this operation is employed. Aschner is probably correct when 

 he states that some of the symptoms ascribed to hypophysectomy by the 

 temporal route may be due to injury of the brain, but he himself is 

 subject to criticism, for he has not controlled sufficiently his operations 

 by histological studies to state with certainty whether or not a total 

 hypophysectomy was achieved. It is quite possible that in many of the 

 adult animals operated upon by him which developed no symptoms after 

 a supposedly complete hypophysectomy, a remnant of the anterior lobe 

 remained. 



Experimental removal of the entire hypophysis indicates that the organ 

 is essential to life. Removal of the anterior lobe is the equivalent of total 

 hypophysectomy. The anterior lobe therefore forms the secretion which 

 is indispensable. 



Partial removal or destruction of the anterior lobe in young animals 

 is followed by a peculiar train of symptoms taking on of fat, genital 

 atrophy, falling of the hair, temporary polyuria and glycosuria, and 

 skeletal changes, which are quite comparable to the changes of dystrophia 

 adiposogenitalis or Frb'hlich's syndrome as observed in man. 



Eemoval of the posterior lobe, in which is included the greater part 

 of the pars intermedia has no early or late results. 



Stalk separation apparently is fatal. It is rather difficult to reconcile 

 this with the fact that removal of the posterior lobe has no effect. It is 

 possible that the operative procedures necessitated in stalk separation or 

 division injure vessels supplying the anterior lobe and that the fatal issue 

 in such cases is determined by anterior lobe changes rather than by the 

 stalk separation alone. 



It has been suggested that many of the changes associated with dys- 

 trophia adiposogenitalis are due to interference with or alteration of 

 posterior lobe secretion which means pars intermedia secretion. There 

 seems to be no experimental evidence to support this claim. 



Feeding Experiments. As pathological evidence accumulated which 

 indicated that acromegaly is dependent upon hypersecretion of the anterior 

 lobe of the hypophysis, feeding experiments were undertaken with the 



