136 
Laboratory  Notes. 
Am.  Jour.  Pharm. 
March,  19 17 
It  is  true  that  certain  diseases  are  definitely  associated  with  ab- 
normalities of  the  pituitary,  and  it  is  perhaps  along  these  lines  that 
the  greatest  advances  may  yet  be  made.  The  dependence  of  growth 
and  the  development  of  sex  characteristics  on  the  anterior  lobe  is  well 
established,  as  is  also  the  connection  between  the  posterior  lobe  and 
normal  metabolism.  The  early  stages  of  acromegaly  and  of  giant- 
ism are  definitely  associated  with  a  hyperactivity  of  the  gland,  while 
hypopituitarism  leads  to  the  syndrome  known  as  dystrophia  adiposo- 
genitalis.  But  the  picture  is  extraordinarily  complicated.  The 
progress  of  acromegaly  may  involve  first  a  hyperplasia  and  later  a 
destruction  of  the  gland,  so  that  the  symptoms  of  hypersecretion  are 
superseded  by  quite  the  opposite  ones.  A  further  complication 
arises  in  that  the  symptoms  may  vary  according  as  the  anterior  or 
posterior  lobe  is  mainly  involved.  Moreover  the  abnormal  func- 
tioning of  the  pituitary  is  ordinarily  associated  with  a  tumor  of  the 
gland,  so  that  the  symptoms  incident  to  its  presence  are  superim- 
posed upon  the  pituitary  syndrome.  Administration  of  the  gland 
or  its  preparations  has  indeed  given  favorable  results  in  the  late 
stages  of  acromegaly,  as  well  as  in  dystrophia  adiposo  genitalis.  But 
it  seems  certain  that  along  this  line  the  greatest  developments  must 
be  still  to  come. 
Along  another  line,  however,  the  pituitary  has  yielded  a  product 
of  wide  therapeutic  interest.  If  a  water  extract  of  the  posterior 
lobe  is  made,  and  proteins  and  other  inert  material  removed,  there 
results  a  solution  of  extraordinary  physiological  activity.  It  is  a 
powerful  stimulant  of  plain  muscle.  It  affects  the  blood  pressure 
and  heart  action.  It  stimulates  the  uterus,  intestines  and  bladder, 
and  exercises  a  definite  action  on  the  activity  of  the  kidneys.  It  is 
upon  these  physiological  properties  that  the  use  of  pituitary  extract 
has  in  the  main  been  based. 
Its  effect  on  the  heart  and  the  blood  vessels  renders  it  valuable 
in  cases  of  shock  and  other  conditions  of  low  blood  pressure.  Its 
use  in  the  shock  following  operative  procedure  has  been  followed 
by  strikingly  good  results.  The  improvement  in  blood  pressure  and 
heart  action  comes  into  evidence  a  few  minutes  after  its  intra- 
muscular injection.  It  has  the  immense  advantage  that  the  effect  is 
persistent,  lasting  as  long  as  from  twelve  to  sixteen  hours.  More- 
over the  tendency  to  reaction  when  the  effect  has  worn  off  is  but 
transitory,  and  the  patient  has  been  tided  over  the  most  trying 
period. 
