ACROMEGALY AND THE HYPOPHYSIS 497 



cause a slight fall in blood pressure (Hamburger *), while the 

 infundibular lobe causes some rise in pressure and slowing of 

 the heart (Howell 2 ). 



That the hypophysis is related to the thyroid there can be no 

 question, for changes in one organ are very frequently associ- 

 ated with changes in the other. Thus Pel, 3 Pope, 4 and others 

 have observed the association of myxedema and acromegaly ; 

 thyroid enlargement is almost constantly found in acromegaly 

 and giantism ; in exophthalmic goiter the hypophysis is often 

 histologically changed (Benda 5 ). In some cases of atrophy of 

 the thyroid an increase in the size of the hypophysis is observed, 

 which resembles a compensatory hypertrophy in that a consid- 

 erable quantity of colloid-like material appears in the gland ; 

 this has been described in myxedema by Ponfick, 6 and in sclero- 

 derma by Hektoen. 7 Many observers state that after thyroid- 

 ectomy a similar compensatory hypertrophy of the hypophysis 

 occurs. Furthermore, the normal hypophysis contains iodin; 

 in fourteen glands that I collected and analyzed the total amount 

 of iodin was 0.05 mg., or an average of 0.0036 mg. for each 

 gland. 8 The proportion of iodin is about one-fiftieth as much 

 as in the thyroid. It is not known whether the iodin is con- 

 tained in the form of thyreoglobulin or not, but the fact that 

 the hypophysis may contain colloid, and that it is embryologi- 

 cally of similar derivation to the thyroid, suggests an affirma- 

 tive answer. 



Metabolism in Acromegaly. Metabolism has been 

 studied in a few cases of acromegaly, 9 and all investigators have 

 observed a decided retention of nitrogen and phosphorus, corre- 

 sponding to the growth of the soft tissue ; and a less marked 

 retention of calcium, because of overgrowth of bone ; an 

 unusually large proportion of the calcium seems to be excreted 

 by the kidneys as compared to the bowels. Excessive excretion 

 of fatty acids without acetone was observed by Edsall and 



1 Amer. Jour. Physiol., 1904 (11), 282. 



2 Jour. Exp. Med., 1898 (3), 245. 



3 Berl. klin. Woch., 1905 (42), No. 44a, p. 25. 



4 Brit. Med. Jour., 1905 (ii), 1520. 



5 Arch. Anat. u. Physiol., 1900 (Physiol. Abt), 373. 

 6 Zeit. klin. Med., 1899 (38), 1. 



7 Cent. f. Path., 1897 (8), 673. According to the studies of metabolism in 

 scleroderma by Bloch and Reitmann (Wein. klin. Woch., 1906 (19), 630) 

 this disease bears a resemblance to thyroid diseases, rather than to gastro- 

 intestinal putrefaction, as has been suggested frequently. 



8 Jour. Amer. Med. Assoc., 1897 (29), 1011. 



'Schiff, Wien. klin. Woch., 1897 (10), 277 ; Moraczewski, Zeitklin. Med., 

 1901 (43), 336; Edsall and Miller, Univ. of Penn. Med. Bull., 1903 (16), 

 143. 



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