1909.] 



TJie Functions of the Pituitary Body. 



451 



be allowed to resume its normal position and the wound closed. The animals 

 show, on recovery from the ansesthetic, at first, as a rule, no adverse symptoms 

 and take their food readily ; but in the course of the second day they begin to 

 exhibit lassitude, and they die, without any very clear cause, within 48 hours. 

 Paulesco performed numerous experiments on various animals belonging to 

 different classes of vertebrata, always with a similar result. Control experi- 

 ments in which there was a rehearsal of the whole operation, but without 

 actual removal of the pituitary, produced no effect ; death, therefore, must 

 have resulted from the removal of this body. 



Similar experiments have been carried out in the Hunterian Laboratory 

 of the Johns Hopkins University, by Harvey Cushing, in conjunction with 

 Eeford (1909). Their experiments have been entirely on dogs, altogether 16 

 in number.* The method employed is in the main that used by Paulesco, 

 but with one or two improvements of technique. The results of complete 

 extirpation were uniform and entirely confirm Paulesco's conclusion. Livon 

 (1909) has also performed confirmatory experiments.! 



These experiments exhibit the serious danger that lurks in any proposal for 

 entire removal of the pituitary for tumours. It is clearly necessary that some 

 portion be left in order that the functions of the gland, which are essential to 

 life, may be carried on. For it. has not been found possible either by 

 grafting pituitary or by feeding with pituitary substance to sustain life after 

 removal of this organ — as in the otherwise analogous case of complete 

 thyroidectomy. 



It is not yet known which part of the pituitary is essential to life. It is 

 almost impossible to remove one part alone, so closely are they dovetailed 

 into one another ; indeed, the pars nervosa and pars intermedia are in direct 

 continuity, and both are almost completely enclosed within the pars anterior. 



Paulesco states that the mere separation of the pars nervosa from the 

 infundibulum has sometimes proved equally fatal with the actual removal of 

 the gland. In view of the discovery by Herring that the secretion of the 

 pars intermedia discharges through the pars nervosa into the infundibulum, 

 this statement of Paulesco is of great interest. But it still requires 

 confirmation. 



* Cushing has since reported 100 cases of total or partial hypophysectomy, ' Journ 

 Amer. Med. Assoc.,' July 24, 1909.— [Note added August 3, 1909.] 



t It has recently been denied by Fichera (1906) and by Gemelli (1908) that destruc- 

 tion of the hypophysis is followed by a fatal result. I am convinced, however, from my 

 own experience, that in such cases the destruction could not have been complete. My 

 experiments in this direction, although less numerous, confirm those of Paulesco and of 

 Cushing and Reford, but I have not thought it necessary in the present communication 

 to refer to them in detail. 



