496 CHEMICAL PATHOLOGY OF THE DUCTLESS GLANDS 



hypothesis that exophthalmic goiter is due to parathyroid in- 

 sufficiency, however, stand the following facts : 



(1) Removal of one lobe of the thyroid often causes im- 

 provement or recovery in this disease, yet with the lobe of the 

 thyroid is generally removed the adjacent parathyroid, which 

 would decrease the amount of parathyroid tissue, and make 

 worse any existing parathyroid insufficiency. (2) Therapeutic 

 administration of parathyroid tissue or extract has had no 

 significant effect on the disease. (3) No considerable or 

 characteristic anatomical changes occur in the parathyroids in 

 exophthalmic goiter, 1 while the great majority of all cases show 

 hypertrophic changes in the thyroid. (4) The parathyroids 

 seem to have no particular influence on metabolism (MacCal- 

 lum), while metabolic abnormalities are very marked in exoph- 

 thalmic goiter. 



ACROMEGALY AND THE HYPOPHYSIS 

 Although in nearly all cases of acromegaly alterations are 

 observed in the hypophysis, yet it has not been conclusively 

 established that the peculiar overgrowth characteristic of this 

 disease, and of giantism, is dependent upon this organ. 2 A 

 great variety of lesions has been described in the hypophysis of 

 acromegalics, adenomatous and sarcoma-like changes having 

 been most frequently observed ; but similar and equally diverse 

 lesions have been observed without acromegaly. 3 All the facts 

 taken together, however, point to hyperactivity of the hypoph- 

 ysis as the cause of acromegaly : in some cases this hyper- 

 activity is associated with gross enlargement, but often the gland 

 shows only histological changes, which consist chiefly of hyper- 

 plasia of the chromophile cells of the anterior lobe (Lewis). 



Equally contradictory and inconclusive are the results of ex- 

 perimental studies of the normal function of the hypophysis, 

 for, while some observers have described muscular tremors and 

 spasms, emaciation, and many other symptoms after extirpation 

 of the hypophysis, other investigators have observed no effects at 

 all. 4 Administration of hypophyseal tissue seems to have no 

 characteristic effects upon either metabolism or the nervous 

 system. Thompson and Johnson 5 found that hypophysis feed- 

 ing causes loss of weight in dogs and increased elimination of 

 nitrogen and phosphoric acid. Extracts of the anterior lobe 



1 MacCallum, Johns Hopkins Hosp. Bull., 1905 (16), 287. 



2 See Mitchell and LeCount, New York Med. Jour., 1899 (69), 517. 



3 Full literature given by Lewis, Johns Hopkins Hosp. Bull., 1905 (16), 157. 



4 Friedmann, Berl. klin. Woch., 1902 (39), 436. 



5 Jour, of Physiol., 1905 (33), 189. 



