22 THE PITUITARY GLAND 



Associated with the enlarged bones of the face, 

 hands, and feet seen in acromegaly, there are in some 

 cases other features ; these are glycosuria, amen- 

 orrhoea, impotence, and, in the young, failure of the 

 secondary sexual characters. The temperature is 

 subnormal. This train of symptoms will recall the 

 effects of total or partial removal of the anterior 

 lobe of the gland in animals. 



Frohlich and others have shown that there is 

 another group of cases, totally distinct from acro- 

 megaly, but again associated with tumours of the 

 pituitary gland. These are characterized by excessive 

 fatness, by infantile stature and development, by a 

 childish type of the genital organs, and by absence 

 of the secondary sexual characters. It may be that 

 we shall yet find abnormalities of the pituitary gland 

 in other varieties of infantilism or of adiposity. 



Most cases of pituitary tumour which have been 

 diagnosed during life have given additional evidence 

 of their presence by involving the optic chiasma and 

 causing blindness of the nasal half of each retina. 



There are already many successful cases on record 

 of removal of a tumour of the pituitary gland in 

 cases of acromegaly. Most recovered from the 

 severe operation, and there was usually a definite 

 shrinking of the enlarged bones. There are also cases 

 in which tumours or cysts of the pituitary have been 

 removed successfully for Frohlich's type of infantilism 

 and adiposity with bi-temporal hemianopsia.* 



* A list of about fifty operations for tumours of the 

 pituitary is given by Bode (Deutsche Zeitschr. f. Chirurg. 

 1911, p. 480. 



