viii, B, 2 Hilario: Tumors of Pituitary Gland 99 



according to general opinion elaborates an internal secretion. 

 Schnitzler and Ewald(i8) have shown experimentally the 

 presence of small quantities of iodine in the pituitary gland. 

 In addition, there is an hypertrophy of the organ after thyroi- 

 dectomy in animals (Rogowitch,(i5) Hofmeister(i)), and in 

 cases of thyroid atrophy in man. The abnormalities of growth 

 and development known as acromegaly and gigantism are in 

 the majority of cases associated with lesions of the pituitary 

 body, such as cysts, hypertrophies, or tumors. In acromegaly it 

 has also been found that the thyroid is sometimes atrophic or 

 cystic, and that the disease can be complicated by myxoedema or 

 exophthalmic goitre. Some relation seems to exist also between 

 the pituitary gland and the genital organs. Nicholls performed 

 an autopsy on a woman about 30 years old with a pituitary 

 tumor, in whom the genitalia were in a marked state of infan- 

 tilism; a similar phenomenon has been observed in man by 

 Pechkranz. (12) Genital deficiency, genital hypoplasia, and mal- 

 formations have been noted with frequency in acromegaly by 

 Garnier et Santenoise,(l) Thoma,(20) and Babinsky.(l) 



Through the observations of Marie (10) it has been recognized 

 that there exists a close relationship between the abnormalities 

 of the pituitary body and the hypertrophy of the bones of the 

 face and extremities, a pathologic condition known as acromegaly. 

 This condition takes place during the age of virility, and its 

 development is slow, up to twenty or more years. There is an 

 enlargement of the face, the superior and inferior maxillary 

 bones being particularly affected ; the ears reach a very large size; 

 the nasal fossae are widened; and the eyelids thickened. The 

 hands and feet are so characteristically enlarged as to be dis- 

 proportionately enormous. 



In generalized gigantism one frequently observes enlargement 

 of the pituitary body. Marie inclined to the opinion that absence 

 of active pituitary secretion induced acromegaly with replace- 

 ment of the pituitary tissue by neoplasm. Schafer(17) to whom 

 together with Oliver and Herring we owe our recent knowledge 

 of the subject, believes with Tamburini and Woods Hutchin- 

 son (1) that the neoplasm is due to overdevelopment of the an- 

 terior lobe, as in some cases a simple hyperplasia of this region 

 has been observed; Von Hansemann(i) affirms that those tumors 

 of the anterior lobe are simple adenomata and not sarcomata, 

 or rather colloid accumulations which are associated with the 

 disease. Schafer suggests that the observations of Marie, in the- 



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