THE PITUITARY GLAND 65 



Arthur Keith, the sponsor of attractive theories on 

 behalf of the endocrine glands, writes, "In giants 

 this gland [the pituitary] is always greatly and 

 abnormally overgrown. We have reasons for sup- 

 posing that it has thrown a drug or drugs into the 

 blood which set all the bone-builders into a state 

 of frenzied activity, producing the dire disease of 

 growth called gigantism." These claims cannot be 

 maintained without many qualifications. 



A case of acromegaly. Of a number of instruc- 

 tive cases described by Gushing in his book on the 

 pituitary a book that has become a classic in 

 medical literature I shall cite one as illustrating 

 the acromegalic who in time actually suffers from 

 hypo-pituitarism in other words, a complex type. 



The case was that of a farmer, age 35, of Dutch 

 extraction and of excellent family history. A hypo- 

 physeal tumor caused pronounced neighborhood 

 symptoms with almost total blindness. There had 

 been a former glandular activity, shown by a ten- 

 dency to excessive overgrowth, traceable to the ado- 

 lescent period ; and by subsequent addition of acro- 

 megalic changes of unusual degree. When admit- 

 ted to the hospital the patient, on the contrary, in- 

 dicated a condition of glandular insufficiency, as 

 shown by adiposity and high sugar tolerance. 



As to his history, nothing unusual was noticed 

 in the farmer until he was 13 years old, when he 

 began to grow with extreme rapidity, and at 19 



