36 SMITH ELY JELLIFFE 



upon closel^ related brain structures will bring about neurological syn- 

 dromes which may be associated with true pineal symptoms or may de- 

 velop solely as symptom pictures of alterations of other anatomical pic- 

 tures without any as yet known pure pineal correlations. These latter 

 neurological syndromes are considered in the succeeding chapter. 



Structural Considerations. Defective pineal states are practically 

 very rare. Two reports of apinealism are alone 011 record at the present 

 time. Experimental removal of the pineal has been discussed elsewhere. 



Zandrens (1921) has given a detailed analysis of an infantile symptom 

 complex in a boy of 10% years who was found to have 110 pineal. This 

 case history will be discussed later. The significance of apinealism in 

 certain animals, crocodiles, for instance, has as yet no explanation. 



Hyperplastic states are better known. These may involve many or 

 few of the tissue elements and are as a rule treated of as tumors of 

 the pineal. 



Cysts. The cystic type of tumor was the first recorded even by the 

 ancients. Virchow studied these and Marburg's (1908) monograph on 

 the subject still presents the chief features known. He treats of them 

 as: (1) Vascular scleroses or thromboses with resultant cystic involution. 

 (2) Retention cysts lined with ependymal cells and resulting from com- 

 plicated embryo logical anomalies or developmental anomalies. Nassetti 

 (1912) has contributed a short study to cystic developments. 



Pineal Sand. This has been known from ancient times, and is more 

 or less universally found. At one time thought of (Marburg, 1. c.) as an 

 inevitable sign of involution, Krabbe (1911) has demonstrated its pres- 

 ence in the very young- and it may be absent in the old. Whether its 

 presence is evidence of disease of the pineal is still a discussable ques- 

 tion, but since the advent of the a-ray has offered an intra-vitam method 

 for finding it (Schueller, 1909), the presence or absence of pineal sand 

 will be more carefully correlated with clinical pictures. Drelincourt, 

 Schnepf, and Boas and Scholz (1918) have reported very large con- 

 cretions. 



Inasmuch as sand concretions are not to be considered as necessary 

 evidence of involution, it may turn out that the other assumed evidences 

 bearing on the non-functioning of the pineal body, such as neuroglia 

 proliferation, pigmentation, etc., will also be found faulty. In fact, 

 Krabbe' s and Schlesinger's (1917) studies on the pineal body in the 

 aged seem to point to a continued functional activity and since Achu- 

 carro's studies on neuroglia have shown this tissue to be a chemically 

 functioning tissue and not a support substance alone, the pathological 

 criteria of involution will have to be revised. 



Hypertrophy. Virchow discussed hypertrophy of the pineal which 

 he observed in a child, dying of measles with hemorrhagic engorgement 



