THE PITUITARY GLAND 63 



This may be due to a tumor in the gland pressing 

 on the optic nerve. But then comes the gradual 

 enlargement of the head and extremities that can 

 leave no further room for doubt. The face becomes 

 big and coarse-looking, the head rather flattened. 

 An X-ray examination of the fingers shows the 

 bones to be enlarged. The entire skeleton in- 

 creases in size, sometimes to huge proportions. 

 Then also we have an overgrowth of hair, under- 

 developed sexual glands, and a probable onset of 

 diabetes, which may, however, be of a temporary 

 nature. 



Cure in acromegaly. We have no easy cure for 

 this disease. Surgical interference may seem an 

 obvious remedy. This is a dangerous procedure, 

 however, and is undertaken only in extreme cases. 

 Fortunately, true cases of acromegaly are rare, and 

 experience has shown that nature and time often 

 act as effective curative agents. 



As a rule the case presented to the physician and 

 surgeon is by no means a clear-cut one. It may 

 be one where hyper-pituitarism predominates, giv- 

 ing us an example of gigantism if the patient is 

 affected early in life, or acromegaly not so pro- 

 nounced as gigantism if later in life; or it may 

 belong to the hypo-pituitary class, with reverse 

 symptoms, such as under-size, adiposity and sexual 

 infantilism, if early in life; or the latter two, if 

 later. But a far more common case, and one that 



