196 



THE SEX-COMPLEX 



Lesions 

 producing 

 insufficiency 

 in the 

 pituitary. 



Distinction 

 between 

 thyroid and 

 pituitary 

 insuffici- 

 encies. 



Treatment 

 with pituitary 

 extracts. 



primary or secondary to hyperplasia ; (3) pressure from 

 tumours in the neighbourhood, or distension of the third 

 ventricle. 



All these conditions may affect the posterior lobe 

 indirectly — that is to say, by causing pressure on it. If 

 the pressure be not too great, and merely irritative, 

 glycosuria is produced, but it is doubtful if other 

 symptoms can be caused by lesions of the posterior lobe : 

 genital disturbances result from lesions in the anterior 

 lobe. This conforms with Cushing's and my own 

 experimental results, but not with Cushing's clinical 

 observations. I think, however, that the confusion in 

 the views of this observer has arisen — if I under- 

 stand him correctly — from the fact that amenorrhcea 

 is seen with hyperplasia as well as with hypoplasia 

 in the anterior lobe. The explanation of this apparent 

 paradox has already been given : hyperplasia in women 

 causes masculinity, and, therefore, indirectly genital 

 hypoplasia with amenorrhcea, while hypoplasia in the 

 anterior lobe directly causes hypoplasia of the genitalia. 

 With both of these pathological conditions sterility co- 

 exists. 



Sometimes there may be difficulty in distinguishing 

 at first sight between thyroid insufficiency and pituitary 

 insufficiency. In both cases there is obesity ; but the 

 site of the lesion may usually be discovered by noting 

 the state of the skin : with thyroid insufficiency it is 

 rough and coarse, and with pituitary insufficiency it is 

 smooth and fine. This observation can be confirmed by 

 the other scientific methods of investigation at our 

 disposal. 



I have found that in minor degrees of pituitary in- 

 sufficiency an extract of the anterior lobe or of the whole 

 gland occasionally produces good results. In the case 

 of a man, who suffered from an extreme degree of 

 dystrophia adiposogenitalis with impotency, and of 

 whose history I have an intimate knowledge, not only 

 did sexual potency return, but his wife subsequently 

 gave birth to a child. I have not come across any case 



