946 INFLUENCE OF DUCTLESS GLANDS ON METABOLISM. 



operation. The symptoms observed were (1) Diminution of the body 

 temperature; (2) anorexia and lassitude; (3) muscular twitchings 

 and tremors, developing later into spasms ; (4) dyspnoea. Many 

 of the symptoms show abatement after injection of pituitary extract. 1 

 Vassale and Sacchi conclude that the pituitary must furnish an 

 internal secretion which is useful in maintaining the nutrition of 

 the nervous and muscular systems. Some of these symptoms, especi- 

 ally the muscular twitchings, are similar to those seen on removal of 

 the thyroid. It has been stated that after thyroidectomy the pituitary 

 body becomes enlarged ; and Eogowitsch 2 has supposed that the fact that 

 in rabbits a thyroidectomy sometimes fails to produce the usual results, 

 is due to the pituitary taking on a vicarious action, the pituitary being- 

 larger in proportion in the rabbit than in most animals. 3 



Similar statements have been made with regard to its enlargement in 

 some cases of myxoedema, in which the pituitary has been examined. But, 

 on the other hand, Schonemann, 4 who examined the pituitary in a large 

 number of cases of goitre, got no distinct evidence of its enlargement in 

 that disease, nor of any constant change in it, although, in common with 

 other structures, it frequently showed pathological alterations. And 

 whereas enlargement and degeneration of the thyroid is accompanied 

 by cretinism and myxoedema, there appears to be a connection between 

 enlargement and degeneration of the pituitary body and an entirely 

 different disease, to which the name "acromegaly" has been given by 

 Marie, 5 the most obvious symptoms of which are hypertrophy of the 

 bones of the extremities and of the face, with some hypertrophy of the 

 skin and mucous membranes, but without mucinoid degeneration. 6 



Effects of extracts. The theory that the thyroid and pituitary 

 may act vicariously, appears to be negatived by the physiological effects 

 which are produced by extracts of the last-named gland, and which 

 differ altogether from those furnished by the thyroid. 7 These differences 

 are exemplified in Figs. 85 and 86, which show that, whereas decoction 

 of thyroid produces no obvious effect upon the contractions of the 

 heart, decoction of the pituitary body causes great augmentation in 

 the force of the heart's beat, without, however, any accompanying 

 acceleration of the rate. Further, the effect upon the arteries is 

 precisely the reverse of that which is obtained by extract of thyroid, 

 for, in place of falling, the blood pressure rapidly rises. That this 

 rise is not due simply to augmentation of the heart's beats, but that it 



1 Brown-Se"quard, Compt. rend. Soc. de Uol, Paris, 1893, p. 527. 



2 Beitr. z. path. Anat. u. z. allg. Path., Jena, 1889, Bd. iv. S. 453. 



3 See also, on the subject of the possible connection between thyroid and pituitary, H. 

 Stieda, Beitr. z. path. Anat. u. z. allg. Path., Jena, 1890, Bd. vii. S. 537 ; Pisenti and 

 Viola, Centralbl. f. d. med. Wissensch.\ Berlin, 1890, S. 25 and 26 ; Hofmeister, loc. tit., 

 1894 ; de Coulon, Virchows Archiv, 1896, Bd. cxlvii. S. 53 ; and Leonhardt, loc. cit., 1897. 



4 Virchow's Archiv, 1892, Bd. cxxix. S. 310. 



5 Brain, London, 1889, vol. xii. p. 59. See also Massalonso, Centralbl. f. Nervcnh. u. 

 Psychiat., Coblenz u. Leipzig, 1895, Bd. xviii. S. 281. A. Schiff (Wien. klin. Wchnschr., 

 1896, Bd. x. S. 277) obtained a marked increased excretion of phosphoric acid on feeding 

 with pituitary tablets, with only a very slight increase of nitrogen. He regards this 

 experiment as indicating an influence of the extract upon the metabolism of bone. 



6 Enlargement of the pituitary only occurred in three cases of acrornegaly out of seven 

 described by Souza-Leite (Neurol. Centralbl., Leipzig, 1890, Bd. ix. S. 447), who states 

 that, on the other hand, persistence of the thymus appears to be a fairly constant accom- 

 paniment of that disease. Dreschfeld (Brit. Med. Journ., London, 1894, vol. i. p. 6) 

 looks upon the enlargement of the pituitary body as a symptom rather than the cause of 

 acromegaly. 



7 Oliver and Schiifer, Journ. Physiol., Cambridge and London, 1895, vol. xviii. p. 277. 



