Am.  Jour.  Pharm.  1 
March,  1915.  J 
The  Pineal  Gland. 
119 
THE  PINEAL  GLAND  IN  RELATION  TO  SOMATIC, 
SEXUAL  AND  MENTAL  DEVELOPMENT.1 
By  Carey  Pratt  McCord,  M.D.,  Detroit. 
From  tumors  involving  the  pineal  gland,  two  distinct  systems 
of  symptoms  and  signs  ensue,  the  neurologic  and  the  metabolic.  The 
neurologic  manifestations  arise  from  the  encroachment  of  the  neo- 
plasm on  the  intracranial  contents  and  are  indications  of  changes  in 
pressure,  in  placement  and  of  destruction  of  tissue.  Such  changes 
are  the  consequence  of  pineal  tumors  at  any  age  of  the  patient;  but 
in  pineal  tumors  appearing  in  prepuberal  life  a  second  group  of 
changes  arises,  the  metabolic.  These  metabolic  alterations  are  ref- 
erable to  disturbance  in  the  gland's  secretory  function.  Apparently 
only  in  young  males  is  this  syndrome  complete.2  It  consists  of  (i) 
early  sexual  development  evidenced  in  the  enlarged  sex  organs, 
pubic  hair,  general  body  hair,  early  changes  in  voice;  (2)  preco- 
cious mental  development  evidenced  in  the  maturity  of  thought  and 
speech,  and  (3)  general  body  overgrowth  to  the  extent  that  a  child 
of  5  or  6  years  may  have  the  appearance  of  a  child  of  11  or  12. 
A  case  reported  by  Machell 3  presents  these  changes  in  a  striking 
manner.  The  patient  was  a  boy  less  than  six  years  old  at  the  time 
of  the  publication.  At  the  age  of  five  months  there  was  pubic  hair, 
erections  at  seventeen  months,  'emissions  at  thirty  months.  The  pa- 
tient's weight  was  yT/2  pounds  above  normal  at  four  months  of  age, 
12  pounds  in  excess  at  8  months,  20  pounds  in  excess  at  three  years. 
When  the  patient  was  forty-four  months  old,  his  height  was  8^4 
inches  above  normal  for  a  child  of  that  age.  At  forty-eight  months 
the  circumference  of  the  head  was  over  two  inches  in  excess  of 
normal.  The  voice  was  a  deep  bass.  Mental  precocity  was  very 
marked  and  the  general  bearing  and  language  was  that  of  a  much 
older  person. 
1  Read  before  the  Section  on  Pathology  and  Physiology  at  the  Sixty- 
Fifth  Annual  Session  of  the  American  Medical  Association,  Atlantic  City, 
N.  J.,  June,  1914.  Reprinted  from  the  Jour.  Amer.  Med.  Assoc.,  July  18, 
1914,  p.  232. 
2  For  review  of  clinical  cases  see  Bailey,  Pearce,  and  Smith  Ely  Jelliffe : 
"Tumors  of  the  Pineal  Body,"  Arch.  Int.  Med.,  December,  1911,  p.  851. 
For  Physiology  and  Anatomy,  see  Vincent  Swale:  "Internal  Secretion  and 
Ductless  Glands,"  1912. 
3  Abstract  taken  from  Medical  Chronicle,  1912,  lvii,  154. 
