866 HAEVEY G. BECK 



generation. The patient showed symptoms verging on cachexia hypophy- 

 sopriva but was kept alive on daily injections of whole gland extract until 

 the gland *was implanted in the subcortical tissues of the temporal lobe 

 by which he was permanently benefited. 



Pharmacological Researches. One of the most important contribu- 

 tions to the study of the pituitary gland was by Oliver and Schafer in 

 1895. These observers demonstrated by intravenous injection of an ex- 

 tract of the whole gland that it contains a pressor substance, causing a 

 rise in blood pressure, thus establishing one of its physiological func- 

 tions. 



Howell(6) in 1898 found that this substance resided in the posterior 

 lobe (pars nervosa and pars intermedia) and that anterior lobe extract had 

 no such effect. Moreover he observed that it exerted an inhibiting in- 

 fluence on the heart's action. Shafer and Swale Vincent in 1899 con- 

 firmed Howell's experiments and further determined that its action on the 

 heart and blood vessels was through the peripheral mechanism. A de^- 

 tailed description of its pharmacological properties will be found in the 

 chapter on Physiology of the Pituitary Gland. 



T. Brailsford Robertson (e) (1916) isolated from the anterior lobe of 

 the pituitary body a lipoid, which contains a growth controlling principle. 

 To this substance he gave the name Tethelin. It comprises about 0.7 per. 

 cent of the fresh anterior lobe tissue and contains phosphorus and nitro- 

 gen in the proportion of 1 :4. The administration of tethelin has the same 

 effect upon growth as anterior lobe extract. 



From the foregoing it will be observed that animal experimentation, 

 feeding of pituitary gland substance, grafting methods, metabolic studies, 

 and pharmacological researches all play an important role in establishing 

 the basis of symptoms in dystrophia adiposogenitalis. 



Neighborhood Signs and Symptoms 



Special Nerve Involvement. These are due to local pressure, which 

 may involve the cerebrum, the base of the skull and the nasopharynx. 

 Injuries to the cerebral nerves give rise to some of the most important 

 neighborhood symptoms. The nerves which are most liable to be in- 

 jured are the optic, and the nerves supplying the eye muscles (III, IV, 

 VI). Nerves more rarely injured are the olfactory, trigeminus, and facial. 



The Visual Disturbances. These depend upon optic nerve lesions 

 and lesions of the chiasm, the result of a hyperplastic struma extending 

 beyond the sellar confines or of a primary infundibular growth. Aside 

 from direct pressure a number of authors (Sachs, Berger, Erdheim, 

 Bartels, etc.) partly attribute the effect upon the optic tract to interference 

 with the blood supply. Visual disturbances are the commonest and the 



