ing, Gull and Ord was termed "hypothyroidism" (diminished secretion or insufficiency). But it was found that, in many cases the two conditions may be blended, as Paracelsus had originally surmised in the Salzburg region, producing an overlapping of the cardinal symptoms of either. For this condition, the term "dysthyroidism" was proposed by Marie for both. In like manner, states of over activity in the pituitary (hyperpituitarism) or of under activity (hypopituitarism) may be superimposed, one upon the other, making the term "dyspituitarism" most appropriate in the majority of cases. As a goitrous mother may have a cretinous infant, so, as originally observed by Crookshank and confirmed by Gushing, a big, bony acromegalic woman may have a son afflicted with pituitary infantilism or obesity. Gushing has also shown that there is evidence of pituitary activity in pregnancy and hibernation (1912) and his experiments upon its relationship to the sympathetic nervous system (1913) have led him to the conclusion that a lesion of the posterior lobe is the principal cause of the increase of normal urine (polyuria) otherwise known as diabetes insipidus. Finally, he had devised a standard surgical procedure for approaching the almost inaccessible pituitary gland, which was first operated upon in man with success by H. Schloffer in 1907. Gushing's work is thus a brilliant contribution to physiological or Hunterian surgery which had almost fallen into abeyance until the twentieth century and which has been the principal means of elucidating the obscure physiology of the ductless glands.
In this connection, it is interesting to note that the first experiment in physiological surgery upon human beings was performed by the gynecologist Robert Battey, of Georgia, who on August 27, 1872, excised the normal ovaries for the relief of a neurotic condition. The physiological basis of this operation, a supposed internal secretion from a specialized set of ovarian cells, has been indicated in many ways. Ovariotomy has been found to have a beneficial effect upon osteomalacia in women. Glass (1899), Morris (1901), Marshall and Jolly (1905) have shown that grafting or transplantation of the ovaries in previously ovariotomized women will reestablish menstruation, sexual desire and general well-being. The experiments of Starling and Lane-Claypole (1906) demonstrated that the inhibitory effect upon pregnancy and lactation of a Battey's operation in rabbits will not be produced by section of the mammary nerves or of the spinal cord. Similarly, the experiments of Brown-Séquard and Poehl on spermin and the fact that ligation of the vas deferens in young animals will abolish the power of reproduction, while permitting full development of the sexual characters and the sexual appetite, go to show that the sexual gonads in the male have an internal secretion, which is supposed to arise from the interstitial cells of Leydig, in the seminal tubules.
(To he concluded)
