If the overaction of the anterior happens after puberty, when the long bones have set, and can not grow longer, a peculiar diffuse enlargement of the individual occurs, especially of his hands and feet and head. The nose, ears, lips and eyes get larger and coarser. As these people are rather big and tall to begin with, the effect produced is that of a heavy-jawed, burly, bulking person, with bushy overhanging eyebrows, and an aggressive manner. For there is, too, something distinctive about their mentality which has been as often portrayed as those of the pathologic giant. Rabelais' most famous character, Gargantua, belongs to the group. We recruit more drum-majors than prime ministers from among these people. They often suffer much from torturing boring headaches, and a consequent despondency and feeling of hopelessness which colors gray the entire spiritual spectrum. Up to a certain point these sufferers have a remarkable alertness and capacity. When conscious of the malady, they often meet it with a doggedly courageous optimism, which is another characteristic, although women occasionally commit suicide.

In both the semi-hibernators who remind one of cattle, and in the giant or acromegalic types who remind one of the anthropoid ape, there develops a distinct diminution of sexual life. An abnormal process in the anterior gland, whether of oversecretion or of undersecretion, may interfere with the proper functioning of the posterior gland, the secretion of which is tonic not only to the brain cells, but also to the sex cells. Thus, young animals deprived of the pituitary will not, if male, grow spermatozoa, nor ripe ova in the female. Moreover, the feeding of pituitary increases sexual activity. In the case of hens, this has been demonstrated to be about thirty per cent by a pretty experiment. At a time of the year when eggs diminish, six hundred and fifty-five hens laid two hundred and seventy-three eggs upon an ordinary diet. When pituitary was added to their food for four days, the number of eggs rose to three hundred and fifty-two, an increase of seventy-nine. In addition, the fertility of the chicks born of these eggs was augmented, especially if both parents had been fed on pituitary. There are other aspects of the relation of the pituitary to sex, which will be treated in another chapter.

THE BONY CRADLE OF THE PITUITARY

Always, in attempting to understand the pituitary, it is necessary to remember that it is tightly packed in the bony cradle, the Turkish Saddle or Sella Turcica. Should some stimulus, local, or in the blood, arouse the gland to growth, a good deal will depend upon whether it has room to grow in, or it will make room by eroding the bone. With space for the formation of a large anterior and posterior pituitary gland, there will be created the long, lean individual, with a tendency to high blood pressure and sexual trends, great mental activity, initiative, irritability and endurance. An outstanding trait of these favorites of fortune is that they remain thin no matter how much food they consume, and they have the best of appetites. They often are subject to severe headaches because of intermittent swelling of the gland against the bone of its container.

If the bony container is or becomes too small for its contents, it is interesting that along with the other signs of pituitary insufficiency, such as undersize, obesity, and asymmetry, there developes conspicuous moral and intellectual inferiority. The unfortunates suffer from compulsions and obsessions and lack inhibitions. They are the pathological liars with little or no initiative or conscience—amoral, not merely theoretically, but instinctively and unconsciously, with all the certitude and perfection of the unconscious accomplishment.

THYROID AND PITUITARY

The thyroid and the pituitary have often been compared. The anterior gland and the thyroid arise from almost the same spot in the embryonic oesophagus, the thyroid being an outgrowth in front, the anterior pituitary an outgrowth behind of the same soil. They both control growth marvelously, also the differentiation, the mass and intricacy of the tissues. But they differ in the site of their control. The thyroid bears more directly upon the inner and outer coverings of the body, the skin, the skin glands and the hair, the mucous membranes, and the irritability and the preparedness for response of the nerves. The pituitary acts more upon the framework of the body, the skeleton and the mechanical supports and movers. Bone and ligament, muscle and tendon seem to be within its immediate sway. The secretion or secretions of the pituitary diffuse directly into the fluid bathing the nervous system, supplying beneficent stimulants and aiding in the abstraction of harmful waste. So while the thyroid raises the energy level of the brain, and the whole nervous system, as a byproduct of its general awakening effect upon all the cells of the body, the pituitary probably stimulates the brain cells more directly, perhaps in the manner of caffeine or cocaine.

The difference between the thyroid and the pituitary might be put this way: that while the thyroid increases energy evolution and so makes available a greater supply of crude energy, by speeding up cellular processes, the pituitary assists in energy transformation, in energy expenditure and conversion, especially of the brain, and of the sexual system. In short, the thyroid facilitates energy production, the pituitary its consumption. The pituitary appears therefore as the gland of continued effort. Hence fatigability, an inability to maintain effort, is one of the prominent complaints when there is destruction or an insufficiency of it for one reason or another. As such, it contrasts with the glands of emergency effort, known as the adrenals.

CHAPTER III

THE ADRENAL GLANDS, THE GONADS, AND THYMUS