PATHOLOGICAL ANATOMY AND HISTOLOGY 781 



scopically, areas of normal histologic structure alternated with places 

 showing the changes observed in the other two cases. Lewis (a) studied the 

 hypophysis of a woman aged 50 years, who suffered from exophthalmic 

 goiter. The stroma of the anterior lobe was increased, the alveoli reduced 

 in size and, although the chromophil elements were normal in number, 

 they were smaller and more vacuolated than in the normal gland. No 

 brown pigment was present. Lewis concluded that this hypophysis did not 

 function normally. Hofstatter (a) also found changes in the hypophysis in 

 this disease, which he thought might be concerned in some of the associated 

 symptoms, for example, the temperature changes, polyuria, polydipsia. 



In congenital ,myxedema and cretinism enlargement of the hypophysis 

 has been described by Comte, Boyce and Beadles (a), Ponfick(a.) (c), Josef- 

 son, Bernardini, and others. In Boyce and Beadles' case the hypophysis 

 weighed 1.21 grams and the anterior lobe "showed every appearance of 

 functional activity. 7 ' Josefson's patient exhibited an adenoma of the hy- 

 pophysis. One of Ponfick's cases showed a small fibrous hypophysis, and 

 in a third the hypophysis was entirely absent. Schoenemann records the 

 case of a cretin whose hypophysis 'was "quite small," the chromophil cells 

 were few in number, and the colloid scanty in amount. De Coulon exam- 

 ined the hypophyses of seven patients showing varying degrees of cretinism. 

 In one, the hypophysis was smaller than normal, in another it was about 

 normal in weight, while in the remainder the weight was from one and 

 onerhalf to three times the normal. The cords of cells were small and 

 did not fill the spaces which they occupied ; colloid was scant ; there was 

 usually an increase of connective tissue and a very noticeable dilatation 

 and overfilling of the blood-vessels. In four of his cases the chromophil 

 cells were numerous. The cases of Zuckermann and Bayon showed in- 

 crease in the number of chromophil cells. 



Boyce and Beadles (a), Comte, Bayon, and Zuckermann believed that 

 the changes in the hypophysis in cretinism were of the nature of a com- 

 pensatory reaction, and an attempt on the part of this gland to act vicari- 

 ously for the thyroid. From a careful study of the cases reported in the 

 literature it is evident that in some cases of myxedema and cretinism the 

 hypophysis is atrophic (Ponfick(a), de Coulon). Whether atrophy of the 

 hypophysis is associated with more severe degrees of myxedema and cretin- 

 ism could not be positively determined from the records at hand. The 

 data available 'are therefore too meager to justify a definite conclusion in 

 regard to the effect of changes in the hypophysis upon these diseases. 



The condition of the hypophysis in cachexia thyreopriva has not been 

 extensively studied in man. Schoenemann mentions the case of a 25-year- 

 old man who, 6 years before death, had undergone a thyroidectomy and 

 thereafter suffered from cachexia thyreopriva. His hypophysis weighed 

 1.59 grams ; the chromophil cells were very numerous and the colloid fairly 

 abundant. 



