782 J. P. SIMOKDS 



The effect of thyroidectomy upon the hypophysis has been made the 

 subject of numerous studies in animals, The majority of investigators, 

 such as Kogowitseh, Stieda, Leonhardt and Cimorini, report enlargement 

 of the anterior lobe following removal of the thyroid in animals. They 

 believe that this enlargement is of the nature of a compensatory hyper- 

 trophy and an attempt on the part of the hypophysis to functionate vica- 

 riously for the thyroid. Trautmann, on the other hand, after an elaborate 

 study of the problem in goats, could not positively determine an increase 

 in size of the hypophysis of the thyroidectomized animals ; and he believed 

 that the alterations which he found in the anterior lobe were of a definitely 

 regressive nature. 



Inflammation 



Pyogenic Infections. Inflammation of the hypophysis may be either 

 acute or chronic. Acute inflammation is usually purulent in character 

 and occurs in two forms: (a) as a relatively large abscess or a diffuse 

 purulent infiltration which may destroy the entire gland or only the 

 anterior lobe; and (b) as minute abscesses, the result of the lodgment of 

 mycotic emboli. The latter are found more frequently in the pos- 

 terior lobe. 



Large destructive abscesses usually occur in connection with some 

 suppurative inflammatory process in the immediate vicinity of the sella 

 turcica. Harvey, Meyer, and Boggs and Winternitz have reported such 

 infections of the hypophysis associated with purulent inflammation of the 

 sphenoidal sinuses; Glinski, Smoler, and Thorn found suppurative hypo- 

 physitis accompanying purulent leptomeningitis. More rarely the forma- 

 tions of large destructive abscesses in the hypophysis is a part of a general 

 pyemia, as, for example, in one of Glinski's cases. Abscesses of the hy- 

 pophysis have also been reported by Heslop and by Battiscombe. The en- 

 tire hypophysis may be destroyed and the sella turcica be occupied by a sac 

 filled with pus, as in the cases of Smoler and of Meyer. In other in- 

 stances the hypophysis may be changed into a soft, dark red, friable mass, 

 densely infiltrated with pus cells without extensive liquefaction necrosis 

 and definite abscess formation, as in the case of Boggs and Winternitz. 



Abscess of the hypophysis being an acute process and usually associated 

 with some other serious disease, death ordinarily occurs before there is 

 time for the development of symptoms of hypopituitarlsm. The patients 

 of Meyer and of Smoler, however, showed marked adiposity ; in the latter 

 there appears to have been a cyst which was operated upon, death follow- 

 ing the operation. Harvey's patient suffered a sudden and complete 

 amaurosis. 



The relative infrequency with which suppuration of the hypophysis 

 accompanies purulent inflammation in adjacent structures is very striking. 



