Twentieth Century History of Findlay and Hancock County, Ohio, and Representative Citizens, Part 113

Author: Jacob Anthony Kimmell
Publication date: 1910
Publisher:
Number of Pages: 1189


USA > Ohio > Hancock County > Findlay > Twentieth Century History of Findlay and Hancock County, Ohio, and Representative Citizens > Part 113


Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).


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Lutopsy .- The naked eye examination of the floor of the third tricle and of the sella turcica disclosed no definite glandular icture. The other organs showed nothing of note beyond a be- ning pneumonia and a mediastinal abscess.


istological .- Microscopical examination of the tissue extirpated operation showed it to consist of the entire, unbroken, pos- or lobe and a large fragment of anterior lobe. Serial sections :he autopsy material disclosed a remaining small group of le anterior lobe cells and the usual tag of pars intermedia- ther words, a " nearly total " extirpation.


omment .- This second case merely serves as another in- ce of an increase in the tolerance to cane sugar by mouth to 120 gms.) after removal of nearly the entire hypophy- It also illustrates the tendency of posterior lobe injection roduce vomiting of ingested sugars. Otherwise the record ` no especial interest. It is another exception to the gen- rule regarding a post-operative spontaneous glycosuria. ptoms of cachexia hypophyseopriva doubtless supervened he intrathoracic infection of obscure origin. A viable nent of anterior lobe was left, sufficient in size to have erved life under ordinary conditions.


57 .- (Series of 1909-10.) Determination of tolerance for venous glucose solutions after nearly total hypophysectomy. Iry fall followed by a secondary rise exceeding the normal. ction of the increased tolerance by the hypodermic adminis- n of posterior lobe extract. Onset of cachexia hypophy- iva on the 12th day. (Table III.)


:e 3 .- A healthy, 7.6 kilo, fox-terrier bitch, about 7 months of apparently full-grown, was observed for six days previous to tion, on the usual standard diet. The animal's normal tol- ? was established at approximately 6 gms. of glucose ad- tered intravenously in 20 per cent solution into the exter- gular.


e 9. Operation .- Extirpation considered as practically to- Fig. 1.) Prompt recovery from the anesthetic. Animal re- I to metabolism cage. No operative or post-operative com- ons of any kind.


HANYUN ZUN INTRAVENOUS INJECTION OF GLUCOSE IN No. 57.


Urine.


Date.


Cubic centi- meters of fluid injected.


Grams of glucose injected.


Amt.


Sp. Gr.


Fehling.


Nylander.


Fermenta-


tion.


Polari-


scope.


June 3


0


0


180


1022


0


0


25


5


200


1040


0


0


5


85


7


/ 100


1030


0


0


of


1%


6


30


6


100


..


+ al.


+ s).


+ sl.


.2%


8


80


6


230


1030


+ s1.


+


+


.2%


9


0


0


400


1015


+


+


+ 81.


.2%


11


0


0


200


1030


0


0


18


17.5


14


25


5


6.25


120


1040


0


0


.


16


0


0


140


1042


0


0


18


35


8.75


110


1084


0


0


20


25 cc. + 0.05 gm. post. lobe hypo.


6.25


60


1044


+


++


.2%


FIG. 1 .- Nine diameters magnification of posterior and anterior lobe of No. 57, removed at operation. Bensley; 5 ; iron-hæmatoxylin. Pars nervosa (P N) . dislocated from its bed in anterior lobe (P A) during removal.


June 9-10 .- Slight post-operative polyuria with spontaneous glycosuria on first specimens voided.


June 10-11 .- Animal in perfect condition. Polyuria and gly- cosuria have subsided.


June 12 .- Four gms. of glucose intravenously caused a reappear. ance of the glycosuria-an amount 2 gms. below the established pre-operative normal.


June 12-20 .- Intravenous tolerance for glucose gradually in- creased during this period, until on June 18 intravenous injection of 8.75 gms. of glucose did not cause glycosuria, but 10 gms. on the following day gave a positive reduction.


Post-operative tolerance therefore estimated at slightly below 10 gms .- 4 gms. over the pre-operative normal.


June 20 .- A smaller dose of carbohydrate, namely, 6.25 gms. of glucose, given coincidently with a hypodermic injection of .05 gm. of posterior lobe extract caused glycosuria.


June 23 .- The animal was sacrificed owing to the onset of symptoms of cachexia hypophyseopriva.


Autopsy .- The naked eye examination of the base of the brain and sella turcica confirmed the operation as a nearly total removal of the gland. No apparent fragments of either lobe. Nothing noteworthy on gross examination of other organs. Tissues pre- served and sectioned in the usual manner.


Histological .- Serial sections of the infundibular region reveal merely a small residual fragment of pars intermedia adjacent to


Digitized by


Google


--


:


4


10


0


0


200


1014


0


0


12


20


4


60


1040


+


+


+


.8%


..


15


25 c. c. 25% sol.


80


7.5


100


1044


0


0


19


40


10


70


1042


+


1.1%


0


0


0


120


1050


0


0


Nearly total hypophysectomy


3.5


90


1050


0


100


1012


0


.


17


PA.


PN


- -


-


( 50


1048


17℃


JOHNS HOPKINS HOSPITAL BULLETIN.


[No. 34


the infundibular stalk (Fig. 2), confirming the practical totality of the extirpation.


Comment .- In this animal an earlier attempt to determine the carbohydrate tolerance by mouth had been abandoned, owing to persistent regurgitation, and recourse was had to the injection methods. The case demonstrates that the tolerance for glucose intravenously behaves in precisely the same man- ner as that for cane sugar by mouth. In other words, there is a lowered assimilation limit for the first few days after opera- tion and a subsequent increase over the normal as determined before operation.


The protocol clearly indicates that in these states of in- creased sugar tolerance the coincident hypodermic injection of a small amount of posterior lobe extract may lower the toler- ance at least for glucose administered intravenously and cause a temporary glycosuria. Attention may be called to the fact that the injection of posterior lobe extracts does not serve to


-PI


C


5


FIG. 2 .- Nine diameters magnification of one of the series from the interpeduncular block of No. 57. Section No. 25; 5 4; Helly; H and E. Showing small fragment of stalk (S) with few adherent pars intermedia cells (P I), organized clot (C), vessels and sellar dura below (D), commissure (D C).


ward off states of threatened cachexia hypophyseopriva, as does the administration of anterior lobe or whole gland ex- tracts. If the whole gland had been used not only might these terminal symptoms have been at least postponed, but the lowering of the sugar assimilation limit would have been shown as well.


No. 66 .- (Series of 1909-10.) Relative tolerance for intra- venous glucose solutions before and after a practically complete hypophysectomy. Demonstration of post-operative increase in tol- erance which could be lowered by the coincident hypodermic in- jection of posterior lobe extract. Acute symptoms of apituitarism on the 12th day. (Table IV.)


June 4 .- A healthy, 6.9 kilo. dog, about one year of age, was confined in a metabolism cage on the usual diet for six days previous to operation. The normal tolerance for 20 per cent glu- cose solutions introduced into the external jugular was estab- lished at about 7.5 gms. 1.08 gr 6. 1.


June 10. Operation .- Usual technique. A supposedly total ex-


TABLE IV .- TESTS OF TOLERANCE FOR INTRAVENOUS INJECTION (F GLUCOSE IN No. 66.


Urine.


Date.


Cubic centi- meters of fluid injected.


Grams of glucose injected.


Amt.


Sp. Gr.


Fehling.


Nylander.


Formonta-


June 4


0


0


140


1030


0


5


0


0


1 90


102d


0


0


R


25


5


₹ 190


1028


0


0


7


35


7


120


1022


0


0


8


40


8


140


1032


+


+


9


37.5


7.5


150


1020


0


0


10


0


0


120


1042


0


0


Total hypophysectomy.


11


0


0


2700


1006


Ist spec +


of


+ o+


12


0


0


700


Some


0


13


0


0


640


1012


0


0


0


0


720


1008


0


0


15


0


0


6 (?)


1040


0


0


16


0


0


720


1008


0


0


17


0


0


510


1010


0


0


..


18


0


:


19


410


feces.


0


0


20


40


8


860


1022


0


0


..


21


40


10


520


1020


0


0


22


45


11.25


820


1016


0


0


23


40 + 0.5 gm. post. lobe


10


120


1020


+


+


hypo.


* Not determined.


tirpation. Gland removed intact. Prompt recovery from tt- anæsthetic. No post-operative complications.


June 11 .- A marked polyuria (2700 cc. in 24 hours), with spe: taneous glycosuria showing only in the first voided specimen. June 12-19. No injections were made during this interval. June 20 .- Injections resumed. Eight grams negative.


June 21 .- Intravenous injection of 10 gms. of glucose in 25 per cent solution-21/2 gms. above the pre-operative tolerance esta's lished on June 9-produced no glycosuria.


June 22 .- An injection of 11.25 gms. was likewise negative showing that the post-operative tolerance was at least more the: 3.75 gms. above the previously established normal.


June 23 .- The intravenous administration of 10 gms. with : coincident hypodermic injection of .05 gm. of posterior lobe er- tract, produces glycosuria.


June 24 .- Animal ill; slow pulse and respiration with subner mal temperature evidence the onset of symptoms of hypophyse cachexia. Sacrificed.


Autopsy .- A total removal, judging from naked eye appearances of the base of the brain. No gross lesions in the other organs


Histological .- The tissue removed at operation proved to be the major portion if not the entire gland. The autopsy specimen showed the presence of an intermediate lobe fragment, and the entire absence of the posterior lobe and characteristic cells of the anterior lobe.


Comment .- This is a second illustration of increase in !! intravenous tolerance to glucose. In twelve days the toleran- rose to more than 3.75 gms. over the normal determined le- fore operation, an increase of 50 per cent. Here again an iz- jection of posterior lobe extract served temporarily to low ?: the acquired degree of overtolerance.


B. Observations on sugar tolerance after deprivation di : portion of the anterior lobe alone.


We have seen that operative removal of the anterior an ! :


posterior lobes together may cause a primary fall and subs- quent rise above the normal in the assimilation limit ir i ----


Digitized by Google


1 120


1040


+


+


+ 81. 5%


0


fece8.


0


450


feces.


0


·


tion.


whether this acquired capacity for storing carbohydrates de- pends upon the loss of either subdivision of the gland singly, or whether it is related to the cessation of function in the structure as a whole.


In the earlier studies from this laboratory particular stress vas laid upon the physiological importance of the pars an- erior. As an outcome of some of the earlier experiments in he present series we became aware that our predecessors had ttributed the post-operative disturbances which they observed Do exclusively to this subdivision of the gland. Their atten- ion had at first been directed more particularly to the acute isturbances leading up to cachexia hypophyseopriva-a state hich supervenes on the loss of the entire gland-and this brupt upsetting of the physiological equilibrium they had roperly ascribed to deficiency of the anterior lobe, for pos- rior lobe extirpation seemed in no way incompatible with te maintenance of life.


So far, however, as the acquired tolerance for carbohydrates concerned a deficiency of the anterior lobe seems to play, at ist relatively, a very insignificant role. This is shown, stly, in negative fashion by the failure of animals deprived a portion of the anterior lobe alone to acquire a high post- erative tolerance; and, secondly, in more positive fashion by > fact that an acquired overtolerance can be lowered much re effectually by the injection of posterior lobe extracts an by the injection of extracts or emulsions of the pars an- ior. Indeed such positive reductions in the assimilation limit actually followed injections of anterior lobe extracts we are lined to attribute to some fragments of pars intermedia t may easily have clung to the anterior lobe during the chanical separation of the two glandular subdivisions in the cess of preparing the separate extracts.


t will be seen in the following experiment that a partial re- val of the pars anterior led to the usual immediate post- rative lowering of tolerance due to the operative manipula- Is. However, there was no subsequent acquirement of over- rance, such as seems to be inevitable when the posterior lobe been removed, whether alone or coincidently with some of pars anterior.


). 50a .- (Series of 1909-1910.) Determination of the assimila- limit for cane sugar by mouth before and after removal of a ment of the anterior lobe. Posterior lobe remaining, though matized. Effect of hypodermic administration of posterior extract on the established tolerance. (Table V.)


w'il 15 .- A healthy, 8.5 kilo, adult fox-terrier bitch. Normal ance for saccharose administered by mouth estimated at t 110 gms. (i. e. between 110 and 115 gms.). It was found this normal assimilation limit could be reduced by the coin- it injection of small amounts of posterior lobe extract. Thus suria would occur with only 70 gms. of sugar given with one- tieth of a gm. of posterior lobe extract.


y 17. Operation .- Removal of a considerable fragment, pos- one-third, of the anterior lobe. The posterior lobe was tly traumatized but was not removed. The animal made a pt recovery from the anesthetic and operation, and remained during the succeeding days of observation. The first speci- voided after operation showed a slight glycosuria.


wow postoperative polyuria. Animal in excel-


lent condition.


May 22 .- 120 gms. of saccharose by mouth showed a reduction. May 24 .- 110 gms. gave a mere trace of reducing substance. Tolerance about the same as before operation (cf. Table V, April 19 and 28).


May 27 .- A hypodermic injection of .05 gm. of posterior lobe extract with 70 gms. of saccharose gave the same degree of glycosuria as on May 5 before the operation. Animal sacrificed.


Autopsy .- Naked eye examination of the base of the brain shows the hypophyseal stalk and much of the gland itself intact. The interpeduncular block and the dura of the sella turcica were dis- sected out as usual in one piece and fixed for sectioning.


Histological .- The small fragment removed at operation proved to be pars anterior alone: no pars intermedia included. Serial sections of the interpeduncular block removed at autopsy showed


TABLE V .- TESTS OF TOLERANCE FOR CANE SUGAR BY MOUTII IN No. 50A. .


Date.


Grams of cane sugar given.


Injection of glandular extracts.


Amt.


Sp.Gr.


Fehling.


Fermen- tation.


Polari- scope.


Apr. 15 :


16


65


350


1010


0


0


0


18


100


300


1020


0


0


0


21


105


400


1040


0


0


0


May


4


90


700


1030


+


+


1.5% D. R.


..


5


70


lobe hypo. .05 gm. post. lobe hypo.


+


+


1.0% D. R.


..


17


Partial hypophy sectomy: fragment of anterior lobe alone removed.


1st


+


+


1.5% D. R.


..


18


860


1008


0


0


0


..


20


850


1008


0


0


0


..


22


120


600


1030


+


:


26


50


.05 wm. post.


400


1010


0


0


..


27


50


.05 gm. post. Jobe hypo.


300


1030


+


+


1.0% D. R.


a normal intact posterior lobe and a large fragment of anterior lobe.


Comment .- Though not a particularly conclusive observa- tion, nevertheless the protocol, when compared with those of the following group, shows that a pure anterior lobe defect without a concomitant posterior lobe lesion need produce little alteration in the carbohydrate assimilation limit. The injection of posterior lobe extract had the same action after operation as before-namely, the reduction of the tolerance from about 110 gms. to something below 70 gms.


This is one of the few cases where a partial removal of the gland without intentional contusion of the stalk caused a transient post-operative glycosuria, sugar being detected in only the first specimen voided after operation.


C. Observations on the sugar tolerance of animals deprived of the posterior lobe and a fragment of the pars anterior, enough of this lobe being left for the maintenance of life.


Removal of practically the entire gland has been shown to produce a transient lowering and subsequent rise in tolerance in the short interval before the onset of the acute terminal symptoms of glandular deficiency. Removal of a portion of


Digitized by


Google


-


17


80


450


1035


0


0


0


19


115


260


1030


+


+


1.3% D. R.


28


110


500


1030


0


0


0


..


17


spec.


19


850


1005


0


0


0


..


21


600


1007


0


0


0


110


700


1030


+ susp.


0


0.7% D. R. 0 0


lobe hypo.


250


1035


0


0


0


.05 gm. post


Urine.


50


172


JOHNS HOPKINS HOSPITAL BULLETIN.


[No. 243


the anterior lobe alone in a single case showed no subsequent increase in tolerance.


As the two following protocols will show the removal of the posterior lobe, together with only a fragment of anterior lobe -- a condition not incompatible with the long maintenance of life-causes the same primary lowering of tolerance and the subsequent rise above the previously established normal.


In the second of these experiments (No. 35), the animal was kept under observation for some five months, and the persist- ence of the established rise in the assimilation limit is well shown, even though a portion of the pancreas had been re- moved before the hypophysectomy.


No. 59 .- (Series of 1909-10.) Determination of the assimila- tion for saccharose administered by mouth after a partial hypo- physectomy including the posterior and a fragment of the an-


TABLE VI .- TESTS OF TOLERANCE FOR CANE SUGAR BY MOUTH IN No. 59.


Urine.


Date.


Grams of cane sugar given.


Dosage of glandular extract.


Amt.


Sp. Gr.


Fehling.


Nylander.


Fermenta-


tion.


scope.


May 17


0


240


1040


0


0


18


80


19


70


240


1022


0


20


90


210


1020


21


100


280


1030


suspic. suspic. +


0


22


110


420


1022


.. 25


0


20


0


26


110


1st spec.


225


1006


0


0


+


.6%


3d spec.


610


1010


0


0


80


1st spec.


65


425


1008


28


70


1st spec.


20


29


60


1st spec.


15


100


1030


+ s1. 0


0


..


30 31


50 70


220


1030


0


0


June 1


80


220


1028


0


0


110


4


120


5


180


8


130


200


1020


+


+


+


.3%


21


110


.05 gm. post.


80


1048


+


+


+


1.5%


29


100


.05 gm. post.


150


1040


+


+


+


28


100


.05 gm. ant.


120


1038


0


0


.


28


100


.1 gm. ant.


100


1060+


+ sl.


+ 81.


+


1.1%


terior lobe. The usual primary post-operative decrease in toler- ance was followed by a secondary rise exceeding the normal. Comparative action of hypodermic injections of posterior and of anterior lobe extracts in reducing the acquired tolerance. (Table VI.)


A healthy, 7.5 kilo, bitch, about nine months of age. Ob- served for six days previous to operation, on the usual standard diet. Normal tolerance established at about 100 gms. cane sugar by mouth.


May 24. Operation .- Satisfactory exposure of gland. Pos- terior lobe and left half of anterior lobe removed without appar- ent stalk injury. No operative complications.


May 25-30 .- Marked post-operative polyuria (2320 cc.). No spontaneous glycosuria observed.


May 25-29 .- Demonstration of greatly lowered tolerance- namely to 60 gms. or less, approximately 40 gms. below the pre- operative normal limit.


May 30-June 4 .- Gradual increase of tolerance to 120 gms. June 5-12 .- Tolerance established at 130 gms. (30 gms. atore normal).


June 22 .-. 05 gm. of posterior lobe extract hypodermicall; caused glycosuria with 100 gms. of cane sugar.


June 26 .-. 05 gm. of anterior lobe extract hypodermical; caused no glycosuria with 100 gms. of cane sugar.


June 28 .- 0.1 gm. of anterior lobe extract hypodermically caused glycosuria with 100 gms. cane sugar, double the dose de posterior lobe extract required.


June 29-July 3 .- Attempts to compare the effect of posteri lobe extract administered by mouth with the subcutaneous dosage proved ineffectual, as 0.2 gm. caused prompt vomiting of the li- gms. of saccharose.


July 23 .- Dog in good condition. Showing no symptoms d. hypophyseal deficiency. Sacrificed. Autopsy conducted as usual


Histological .- The tissue removed at operation consisted of the intact posterior lobe together with a large fragment of pars as- terior. The interpeduncular block removed at autopsy showed a considerable residue of viable anterior lobe together with a sma" remnant of pars intermedia.


Comment .- There was an unusually high grade of pet- operative polyuria in this case, and unfortunately the fr: voided specimens were not secured and tested for sugar. A: the marked diuresis and spontaneous glycosuria usually s. hand in hand, both presumably representing the introductie: into the circulation of excessive amounts of posterior lis secretion, a transient glycosuria might have been expectel. However, a temporarily lowered tolerance (40 gms. below te- normal) was demonstrated even to the sixth day (May 291 after the operation. Had we been making a quantitative study this would have been apparent earlier, namely, on the third day (May 16), when 110 gms. gave an abundant redue- tion, as it did before the operation. By the 13th day (Jur: 5), the tolerance had risen to 130 gms. (30 gms. above the normal), where it remained about stationary for three days. It may possibly have risen to a higher level subsequently, bar no further tests were made unassociated with the injection i? extracts.


It can be seen that .05 gm. of posterior lobe extract admin- istered hypodermically served to restore the post-operative tolerance practically to the former pre-operative level of 1ik gms. This may therefore possibly represent the degree ?! secretory insufficiency of the posterior lobe. Double this amount of anterior lobe extract was needed to produce the same effect. However, as we have stated, this tolerance lower- ing action of pars anterior extract is in all likelihood due iz large measure to the almost unavoidable incorporation d some of the pars intermedia in the preparations.


Several attempts were made to estimate the relative amounts of posterior lobe, given by mouth and administered hypodermically, in producing glycosuria with the 100 gm doses, but the ingestion of the extract invariably caused vomit- ing of the sugar.


No. 35 .- (Series of 1909-10.) Determination of the assimilaties - limit for saccharose of an animal deprived of the posterior and G portion of the anterior lobe. Rise in assimilation limit to dost) the previous normal. (Table VII.)


With the thought in mind, as indicated in our introductory paragraphs, that the alterations in carbohydrate tolerance migt:


Digitized by Google


(


0


0


170


1030 1034


0 0


0


210


1030


+ 81.


+ 81.


+


1.2%


..


12


180


180


1040


+ 8].


+ 81.


1.2%


lobe hypo.


170


1040


0


0


2


100


200


1027


0++


+


.8%


2d spec.


260


1022


0


..


24


Hypophysectomy; post. lobe and fragment of ant. lobe removed.


1750 2820


1008


0


0


+


2d spec.


40


+ +


+ +


2.3%


27


+


2d spec.


2d spec.


+


8


0


820


..


lobe hypo.


lobe hypo.


lobe hypo.


360


0


07 +0+


Polari-


mw auxmais in the series were subjected to a pancreatectomy, [ of the gland but its duodenal attachment being extirpated. the following case as a result of this operation the usual spon- neous pancreatic glycosuria occurred, but the normal tolerance is soon regained. The hypophysectomy was performed two onths later.


December 29, 1909 .- A healthy, full-grown, 7.5 kilo, dog, about


ABLE VII .- TESTS OF TOLERANCE FOR SACCHAROSE BY MOUTH IN No. 35.


Jate.


Grams of cane sugar given, and dosage of glandular extract.


Amt.


Sp. Gr.


Fehling.


Nylander.


Fermenta-


tion.


Polari-


3. 29 30 31


0


100


1055


+ sl.


+ sl.


+


.35% D. R.


0


125


1050


0


0


50


150


1025


0


0


60


200


1030


+


+


.4% (8 gm. 24 hrs.)


25 26


60


120


1035


0


0


70


400


1015


0


0


27


80


200


1040


0


0


90


200


1040


+


+ 0


+


.5% D. R.


1 4


Hypophysectomy posterior lobe and large fragment anterior lobe.


1st spec. 2d spec.


160


1050


1


+


+


50


450


1020


0


0


70


375


1038


0


0


80


400


1035


0


0


100


140


1042


0


0


140


140


1060 1040 1042


0 0 - 81.


+


180


320


1040


+ 81. + sl.


+ 8l. + sl.


+ 1% + + 1%


180


60 (?)


1060+ 1044


1080


+


+


3%


23


100 + .05 gm. post. lobe hypo.


150


1036


+


+


1%


24


60 (?)


1048


+


+


.7%


28


180


1040


0


0


0


30 1


300 (?) 300


1060++


+


0


0


0


5 9


170


360


1060


0


0


0


40(?)


1050


0


0


A few bubbles


10


250


1020


+


+


1.2%


11


80 (?)


1048


+


+


+


.4%


12


95


1040


0


0


0


0


13


140


1030


0


0


0


15


80


1060


0


0


slight (?)


0


16


35 (?)


1060


0


0


0


23 24


100 360


1058 1040


to


+


+


4%


year of age, was deprived of a large portion of the pancreas. , pre-operative tolerance for saccharose by mouth was not lished for this individual animal but from our subsequent "iences it can be approximately estimated at 80 to 90 gms.) animal made a good recovery from the anaesthetic and there no surgical complications.


cember 30 .- A spontaneous glycosuria with reduction of ng's solution; positive Nylander and fermentation tests and trorotatory substance present. Though the specific gravity


day.


January 31-March 1 .- Assimilation limit for saccharose rose from 60 gms. on February 1 to 90 gms. on February 28, presum- ably the animal's normal assimilation limit.


March 4. Operation .- Hypophysectomy with removal of pos- terior lobe and all but a small fragment of anterior lobe. An easy case; no surgical complications.


March 5 .- Though the first specimen voided after operation showed glycosuria, 50 gms. of sugar on this date were negative.


March 7-17 .- Increasing amounts of sugar failed to give glyco- suria until 160 gms. led to a slight reduction-70 gms. over the pre operative normal.


March 18-April 5 .- Further rise in tolerance until 180 gms. gave faint reduction and 170 gms. proved negative.


April 22-26 .- Determination of assimilation limit for saccha- rose, administered with a coincident hypodermic injection of 0.5 gm. posterior lobe extract, showed that glycosuria then oc- curred with a sugar dosage of between 80 and 90, a lowering of the established tolerance by one-half. In other words, this dose of glandular extract practically restored the pre-operative tolerance.


April 30-May 5 .- Demonstration of persistence of the acquired overtolerance at about 180 gms., double the pre-operative normal.


May 9-16 .- Determination of assimilation limit with coincident hypodermic administration of .05-0.1 gm. anterior lobe extract showed that this extract is much less potent in reducing the ac- quired tolerance than is extract of posterior lobe. In other words, 140 gms. of sugar (May 11) was necessary to give glycosuria with .05 gm. of the extract, and double this dose of extract failed to give any reducing properties with 130 gms.




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