PINEAL GLANDS 95 



is explained as hypopituitism succeeding an excess. 

 The same alternation is seen in diseases of the thyroid 

 gland. 



A very valuable measure of the function of the 

 pituitary gland may be obtained by observations on 

 the power of warehousing sugar. If the internal 

 secretion is deficient, huge quantities of glucose will 

 not cause glycosuria. This is the cause of the adipo- 

 sity. Hypopituitism is usually due to malignant 

 growths encroaching on the gland, and is frequently 

 followed by death. 



We are now in possession of some indications for 

 treatment. Acromegaly and gigantism do not usu- 

 ally require anything to be done. Pituitary feeding 

 does more harm than good. If there are symptoms 

 of cerebral compression or gradually increasing blind- 

 ness from involvement of the optic chiasma, an 

 operation may be performed to relieve pressure and 

 remove part of the gland. Scores of cases have now 

 been treated in this way (Gushing reports 43 operated 

 on by himself), and the mortality is not high. Several 

 observers record a definite shrinkage of the bones' 

 afterwards. 



Patients suffering from the Frohlich type may be 

 treated by pituitary feeding, the whole gland of 

 cattle being used. The dose is about 12 grains a day. 

 This may be worked out by its influence on the sugar 

 tolerance. Remarkable results have been obtained 

 in a few cases. If there are signs of intracranial 

 pressure a decompression operation is indicated. 



The hope that pituitary feeding would prove to be 

 a remedy for increasing the stature of small children 



