I ill. ITU [TAB1 BOOT 



After a time the disease begins to affect the pars intermedia el nervoi 

 and disturbances in carbohydrate metabolism come to be observed, con- 

 sisting usually in a diminished tolerance a impanied by glycosuria, in 



the early stages of the disease, followed by increased tolerance in the 

 later stages. The glycosuria is usually accompanied by marked polyuria. 



It should be qbserved thai sometimes tumor of the pituitary lias been 

 found to exist postmortem though none of the above symptoms had been 

 recorded during life. In these cases it is probable that the dia rom 



the start had been of such a nature as to produce a tendency to hypo- 

 pituitarism rather than hyperpituitarism, for the symptoms are very like 

 those observed in animals after partial or complete removal of the gland, 

 [f the condition commences before adolescence, the body fails to grow, 

 although the child may continue to increase in weight because of the 

 remarkable deposition of fai in the tissues. Sexual development is strik- 

 ingly interfered with, ami the secondary sexual characteristics fail to 



show themselves. In hoys, for example, the pubic hairs fail to extend up 



to the umbilicus; ami the hairs on the chin do mu develop, whereas tin- 

 hair of the seal]) grows profusely. The hones remain of the female t; 



and a broad pelvis, rounded Limbs, small feet ami hands are often ob- 

 served. In these eases there is usually excessive tolerance for carbohy- 

 drates, which may explain the adiposity, sii'_ r ar being converted into fat. 

 In the lighl of the experimental results, the effect on carbohydi 

 metabolism may he explained as due to involvemenl of the posterior 

 lobe. .Mental development is retarded, ami psychic derangements are 

 somel imes obsen rt\. 



Where the hypopituitarism does not develop until after adolescent 



some of the above symptoms will of course he missed, hut many will he 

 observed, such as dryness of the skin, loss of hair, and the tendency in 

 the male to adopt certain of the female characteristics, particularly with 



regard to the growth id' hair. Obesit) and increased tolerance he 

 are also evident, and pigmentation of the skin, something like thai 

 Addison's disease, is said often to he a prominent feature. Operative 

 interference in the early stages in many of these cases is of undoubted 

 benefit, as is shown bj the brillianl work of Harvey dishing, to which 

 the reader is referred for further information. 



The Relationship of the Pituitary Gland with Other Endocrine 



Organs 



The relationship of the pituitary gland with other endocrine organs 



nc ems to he an intimate one. 



I. With the Thyroid and Parathyroid Glands. Thai enlargemenl 

 the pituitary occurs after thyroidectomy in man has been known for a 



