PITUITARY EXCESS 197 



either in the literature or in my own experience in which Treatmont 

 a woman suffering from a major degree of pituitary ^tracts? 1 *" 7 

 insufficiency has become pregnant. 



We have already seen that infundibular extract 

 appears to act as well as suprarenal medullary extract in 

 the treatment of osteomalacia ; it is possible, therefore, 

 that there is a minor degree of insufficiency of this part 

 of the pituitary in this disease ; but it is more likely that 

 a good result is obtained because this extract is antagon- 

 istic to the ovarian secretion in regard to the calcium 

 metabolism. 



Excess of pituitary secretion.— As a rule, hyper- Hyperplasia 

 plasia of the pituitary commences at puberty; but°? t ^ 

 there is no reliable evidence that hypoplasia in the acromegaly, 

 gonads induces the condition. Nevertheless, it has 

 been stated by Kalledey 1 and others that intravenous 

 injections of ovarian extract will cure acromegaly. It 

 must be remembered, however, that this disease shows 

 remarkable remissions, even with the return of men- 

 struation for many months. In Kalledey's case the 

 patient became pregnant, but parturition had not 

 taken place at the time his paper was written. 



In connexion with acromegaly it is interesting to note 

 that there is considerable calcium retention in the bones 

 and tissues of the patient — a masculinity-producing 

 phenomenon which would be incompatible with menstrua- 

 tion and pregnancy, as already explained. 



For the same reason an increase in sexual excitability 

 is never seen in women at the onset of acromegaly — a 

 phenomenon described by Cushing 2 and others as 

 sometimes occurring in men in these circumstances. 



It is, of course, well known that an increase in the Hyperplasia 

 activity of the pituitary— particularly in the pare^J^JJ 

 anterior — is to be found normally in pregnancy. Some- pregnancy. 

 times acromegalic symptoms, such as enlargement of the 

 lips, tongue, lower jaw, hands and feet, have been 



1 Kalledey, L., ZentraM.f. Gynak., 1913, vol. xxxvii, p. 1030, 



2 Cushing, H., The Pituitary Body and Its Disorders, 1912. 



