946 INFLUENCE OF DUCTLESS GLANDS ON METABOLISM. 
operation. The symptoms observed were — (1) Diminution of the body 
temperature ; (2) anorexia and lassitude ; (3) muscular twitchings 
and tremors, developing later into spasms ; (4) dyspnoea. Many 
of the symptoms show abatement after injection of pituitary extract. 1 
Yassale and Sacchi conclude that the pituitary must furnish an 
internal secretion which is useful in maintaining the nutrition of 
the nervous and muscular systems. Some of these symptoms, especi- 
allv the muscular twitchings, are similar to those seen on removal of 
the thyroid. It has been stated that after thyroidectomy the pituitary 
body becomes enlarged ; and Kogowitsch 2 has supposed that the fact that 
in rabbits a thyroidectomy sometimes fails to produce the usual results, 
is due to the pituitary taking on a vicarious action, the pituitary being 
larger in proportion in the rabbit than in most animals. 3 
Similar statements have been made with regard to its enlargement in 
some cases of myxoedema, in which the pituitary has been examined. But, 
on the other hand, Schonemann, 4 who examined the pituitary in a large 
number of cases of goitre, got no distinct evidence of its enlargement in 
that disease, nor of any constant change in it, although, in common with 
other structures, it frequently showed pathological alterations. And 
whereas enlargement and degeneration of the thyroid is accompanied 
by cretinism and myxoedema, there appears to be a connection between 
enlargement and degeneration of the pituitary body and an entirely 
different disease, to which the name "acromegaly" has been given by 
Marie, 5 the most obvious symptoms of which are hypertrophy of the 
bones of the extremities and of the face, with some hypertrophy of the 
skin and mucous membranes, but without mucinoid degeneration. 6 
Effects of extracts. — The theory that the thyroid and pituitary 
may act vicariously, appears to be negatived by the physiological effects 
which are produced by extracts of the last-named gland, and which 
differ altogether from those furnished by the thyroid. 7 These differences 
are exemplified in Figs. 85 and 86, which show that, whereas decoction 
of thyroid produces no obvious effect upon the contractions of the 
heart, decoction of the pituitary body causes great augmentation in 
the force of the heart's beat, without, however, any accompanying 
acceleration of the rate. Further, the effect upon the arteries is 
precisely the reverse of that which is obtained by extract of thyroid, 
for, in place of falling, the blood pressure rapidly rises. That this 
rise is not due simply to augmentation of the heart's beats, but that it 
1 Brown-S&mard, Compt. rend. Soc. de bioh, Paris, 1893, p. 527. 
2 Beitr. z. path. Anat. u. z. allg. Path., Jena, 1889, Bd. iv. S. 453. 
3 See also, on the subject of the possible connection between thyroid and pituitary, H. 
Stieda, Beitr. z. -path. Anat. u. z. allg. Path., Jena, 1890, Bd. vii. S. 537 ; Pisenti and 
Viola, Centralbl. f. d. mcd. Wissensch., Berlin, 1.890, S. 25 and 26 ; Hof'meister, loc. cit., 
1894 ; de Coulon, Virchow's Archiv, 1896, Bd. cxlvii. S. 53 ; and Leonhardt, loc. cit., 1897. 
4 Virchow's Archiv, 1892, Bd. cxxix. S. 310. 
5 Brain, London, 18S9, vol. xii. p. 59. See also Massalongo, Centralbl. f. Xervcnh. u. 
Psychiat., Coblenz u. Leipzig, 1895, Bd. xviii. S. 281. A. Schiff {Wien. klin. Wchnschr., 
1896, Bd. x. S. 277) obtained a marked increased excretion of phosphoric acid on feeding 
with pituitary tablets, with only a very slight increase of nitrogen. He regards this 
experiment as indicating an influence of the extract upon the metabolism of bone. 
6 Enlargement of the pituitary only occurred in three cases of acromegaly out of seven 
described by Souza-Leite {Neurol. Centralbl., Leipzig, 1890, Bd. ix. S. 447), who states 
that, on the other hand, persistence of the thymus appears to be a fairly constant accom- 
paniment of that disease. Dreschfeld (Brit. Med. Jov.rn., London, 1894, vol. i. p. 6) 
looks upon the enlargement of the pituitary body as a symptom rather than the cause of 
acromegaly. 
7 Oliver and Schiifer, Journ. Physiol., Cambridge and London, 1895, vol. xviii. p. 277. 
