In animals (rabbits), excepting dis turbances evidently due to local infec tion produced by the subcutaneous in jections, very slight effects were ob tained: a transient elevation of tempera ture, most marked two hours after the injection. Injected into the veins it produced disturbances similar to those obtained after injection of blood, namely: death from coagulation. If treated by sodium chloride or by heat it produces results similar to those of blood-serum when similarly treated, but it is dis tinguished only by a more marked my osis; and given by the mouth, macerated or triturated pituitary gland causes, besides a slight elevation of temperature, a noticeable gastrointestinal disturbance and a temporary albuminuria, showing that this substance possesses only a slight degree of toxicity. With dogs nothing of importance is noticed: slight emaciation and slight elevation of tem perature. With healthy men the same results were reached. Mairet and Bose (Arch. de Phys., No. 3, p. GOO, '96). It is probable that the pituitary gland bears some unascertained relation to the nutrition of bony and dermal tissues, as a result of which an overgrowth of them accompanies changes in the gland which presumably affect its functions. Whether or not these changes are pri mary is yet unknown. F. P. Kinnicutt (Amer. Jour. Med. Sciences, July, '97). The pituitary gland is a functional organ, disturbances of the metabolism of which are the principal factors in both aeromcga]y and giantism, the differences between the results being due to the stage of individual development at which the disturbance of function begins. Woods Hutchinson (N. Y. Med. Jour., July 21 and 28, 1900).
acromegaly it can not be said to have done much more than to relieve some of the active symptoms and to have contributed to the patient's comfort. This means considerable in these cases, which sometimes suffer greatly from neuralgic pains, violent headaches, etc.
Statistics of 13 cases of acromegaly treated with pituitary preparations: In 7 cases varying degrees of improvement were noted. In 1 of these the improve ment occurred under the combined use of pituitary and thyroid preparations. In 5 cases no effect was obtained; and in 1 case the patient was made worse by the treatment. F. P. Kinnicutt (Amer. Jour. Med. Sciences, July, '97).
Administration of the tablets for months at a time having failed to amelio rate the symptoms of acromegaly in per sonal cases, and the fact that extirpation of the pituitary gland in dogs and in man (when the hypophysis cerebri has been the seat of a destructive process, such as sarcoma) is not followed by any of the pathognomonic symptoms of acro megaly, would seem to prove that acro megaly it not due to obliteration of the glandular structure of the hypophysis, and that this alleged remedy has been used only empirically and is absolutely inefficacious. W. M. Leszynsky (Med. Record, June 30, 1900).
Organic Extracts.
Preparations of the various organs, the spleen, the ovaries, bone-marrow, the tes ticles, the brain and nerves, the kidneys, the lungs, the liver, and the pancreas have all been tried as remedial agents; hut it niay be said that, while only the products of the first five have attracted wide-spread attention, those of the spleen and ovaries alone seem to present suffi cient value over other means at our dis posal to still merit the confidence of the profession.
The preparations of the first five or gans mentioned in the list will be re viewed in this article. The literature of the others is so scanty that no adequate idea could be conveyed of their actual worth.
Strength of organic extracts may be tested by adding to them Biondi's stain ing-fluid. If nuc]ein is present in large amount and the extracts therefore are of good quality. they will turn a distinct green. Posner (Berliner kiln. Woch., Mar. 14, '93).
Splenic Extract.
The use of spleen was suggested mainly by the fact that enlargement of that organ occurs in some cases of cretinism and myxcedema and after removal of the thyroid gland. This was further sub stantiated by the experiments of Oliver and Schiifer, who obtained a fall of arte rial pressure followed by a gradual, but steady, rise, by means of intravenous in jections of splenic extract, thus demon strating that it was not inert. Kruger found that it increased the excretion of uric acid and of the xanthin bases.
Effect of spleen substance administered to a number of patients in the Lanark County Asylum, Hartwood, investigated for a period of two years. It was found to aid digestion and nutrition, to increase the cutaneous circulation, to stimulate the glandular activity of the skin, and in some cases to produce a favorable change in the mental condition. A. C. Clark (Edinburgh Med. Jour., Feb., '9S).
Results of investigation of therapeutic value of spleen extract. Treatment was begun with three capsules of desiccated spleen representing 100 grains each of fresh spleen; this was increased to 6 cap sules a week later. Capsules of liquid extract, each containing 20 grains of fresh spleen, were tried some weeks later, and with more distinct benefit. Conclu sions are: 1. That the most general result of this treatment is improvement.
2. That its action on the mental state is undoubtedly evident in a fair propor tion of cases, especially of adolescents, sometimes direct, at other times owing to improved physical conditions.
3. That it materially assists in render ing thyroid treatment efficacious, the pa tient, after a course of spleen treatment, being more susceptible to the action of thyroid.
4. That where it fails there may be a defect in the preparation of the extract. We have found that capsules of the liquid extract are best. They have been made for us by Duncan, Flockhart & Co. The desiccated spleen, which is usually employed for tablets, must necessarily lose some of its active properties.
5. It is best given at least half an hour before meals. Charles A. Bois and Neil 'I'. Kerr (Brit. Med. Jour., Sept. 10, '98).
Administration. — Two practical dif ficulties are met with in administering splenic extract: it produces gastric pain and derangement of the digestion when given by mouth, and great local irritation and even abscesses when administered hypodermically, although, of course, this does not always follow. A splenic ex tract employed by Cohnstein is known by the trade-name of "eurythrol." It is a watery extract to which salt has been added, partly to preserve it and partly to give it a better flavor. It is described as resembling Liebig's beef-extract. The amount to be given daily is from 1 to 2 teaspoonfuls, dissolved in hot water. It does not seem to occasion distress.