THE PITUITARY 381 



Gilford thinks that many forms of infantilism are due to 

 quite other causes than deficiency of internal secretion. Thus 

 ateleiosis (delay of development, sexual organs being most 

 delayed) is a mutation, and as such is liable to be associated 

 with other anomalies of development such as those of the 

 thyroid or pituitary. These are, however, secondary, and not 

 the cause of the condition. 



Ackondroplasia (chondrodystrophia foetalis). Achondro- 

 plasic dwarfs resemble cretins, but shortness of the limbs is 

 more noticeable in the former. According to some authors, 

 the condition of achondroplasia is distinguished from chondro- 

 dystrophia, the former being due to hypof unction of the repro- 

 ductive organs arising in utero, the latter being the result of 

 hypofunction of the anterior lobe of the pituitary arising in 

 foetal life. The latter is sometimes a cause of brow presenta- 

 tion and dystocia. According to some writers, there is a 

 diminution in size of the sella turcica, and pituitary extract 

 should be tried. The patients are not benefited by thyroid 

 treatment. 



The condition has to be diagnosed from cretinism and 

 rickets. 



The disease is, in brief, a foetal disorder which causes a 

 defective growth of certain of the bones in utero and leads to 

 congenital dwarfing of the extremities and other deformities 

 which persist throughout life. It is said that there is an 

 abnormal arrangement of the cartilage cells along the line of 

 ossification. 



The obscurity involving the condition is shown by the very 

 numerous names which have been employed to describe it. 

 In addition to the above-mentioned names, the disease is 

 referred to as Rachitis fcetalis, Pseudorachitism, Pseudorachitis 

 foetalis micromelica , Cretinoid dysplasia, Chondritis fcetalis, 

 Micromelia. 



There is no certain proof that the typical cases of Achondro- 

 p^sia arise from any disorder of any of the glands of internal 

 secretion. 



Carbohydrate Tolerance in Pituitary Disorder. An increased 

 tolerance for carbohydrate has been recognized for some years 

 as a test for pituitary insufficiency. One of the recognized 

 methods of conducting this test is as follows : Twenty-five, 

 fifty, or a hundred grammes of glucose dissolved in 150 c.c. of 



