94 THE PITUITARY AND 



specially at fault ; it may be disproportionately 

 enlarged, and may show a superabundance of secre- 

 tion granules. 



Now, however, there is a tendency to unify the 

 functions of the hypophysis ; and to regard it as one 

 gland, although the distribution of the colloid is 

 unequal in the various parts. 



Whether the gland is necessary to hfe is unsettled ; 

 probably it is not. 



The diseases fall into two groups : those in which 

 the internal secretion is excessive (hyperpituitism), 

 and those in which it is diminished or absent (hypo- 

 pituitism) . 



Hyperpituitism is characterized by signs of acrome- 

 galy in adults, or gigantism if it begins before growth 

 has ceased. The gland is usually enlarged, showing 

 microscopically a simple overgrowth. There may 

 be glycosuria. The cases run a chronic course for 

 years unless symptoms of cerebral compression 

 come on. 



Hypopituitism produces the Frohlich type, with 

 atrophy of the genitals, infantihsm, and excessive 

 fatness. There is often a drowsy mental state ; 

 indeed, one is tempted to beheve that that very 

 accurate observer, Charles Dickens, must have had 

 such a case in mind when he invented the immortal 

 Fat Boy in Pickwick. All these symptoms can be 

 mimicked by partial excisions of the pituitary gland 

 in animals. Cushing's results as to which lobe is at 

 fault are discordant. 



It is true that cases of acromegaly may eventually 

 develop impotence, sterihty, and amenorrhoea ; this 



