Did Napoleon Bonaparte suffer from hypopituitarism (dystrophia adiposo-genitalis) at the close of his life? / by Leonard Guthrie.

  • Guthrie, Leonard George, 1858-1918.
Date:
1913
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Licence: In copyright

Credit: Did Napoleon Bonaparte suffer from hypopituitarism (dystrophia adiposo-genitalis) at the close of his life? / by Leonard Guthrie. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    the matter, it seems to be fairly well established that the <pa/rs anterior, or glandular portion, is chiefly concerned in regulating skeletal growth, sexual activity, and temperature. Whereas the posterior part, or pars nervosa, which includes the pars intermedia, is more closely allied to metabolic processes and especially to the metabolism of sugar, ‘ ‘ and also probably serves to promote contractility and tone of plain muscular tissues generally, as well as of the heart, and to excite the activity of certain glands—viz., the kidney and mammary gland.” (Schaefer.) Gigantism in early life and acromegaly in later life are regarded as indications of hyperpituitarism on the part of the anterior lobe. Keith supposes that in such cases the organ supplies “ hormones ” which render osteoblasts more sensitive to mechanical and other stimuli. Hitherto it has not been found possible to produce hyperpituitarism in the shape of gigantism or acromegaly experimentally. Clinical evidence in favour of the view that acromegaly is due to hyperpituitarism is that in some cases during pregnancy, when the gland is known to become enlarged, transient signs of acromegaly have been observed. But the theory is mainly an inference drawn from the fact that experimental hypo- pituitarism (partial extirpation of the anterior lobe) causes “acromegaly reversed,” i.e., shortening of the skull, and diminution in the size of the limbs (Crowe, Cushing, and Homans). The other effects of experimental hypopituitarism are atrophy or ill-development of the genitalia, loss of sexual hair, feminine characteristics of the pelvis and skin in males, obesity, and lowered temperature. The influence of the anterior lobe on temperature is shown by the thermic reaction which is produced by injection of anterior lobe extract in cases of definite hypopituitarism. In normal individuals, however, no such thermic reaction takes place. Cushing explains the paradox that gigantism and acromegaly are often, if not usually, associated with dystrophia adiposo-genitalis, by supposing that the exit of the secretion of the posterior lobe into the third ventricle through the infundibulum is blocked by a tumour. He finds that adiposity may attend tumours of either anterior or posterior lobe. Hypopituitarism of the posterior lobe is also indicated by diminished metabolism, diminished consump- tion of oxygen and lessened output of COj, and a high degree of tolerance of sugar, which is turned into fat and stored in that form in the tissues, thus accounting for the obesity. The functions of the pa/rs intermedia are far from being decided. They are probably not the same throughout life. In childhood the cleft between the anterior and posterior lobes is wider than in later life. Erdheim and Thom have described changes which occur in the hypophysis at about the age of 40, • ‘ when the basophil cells of the pars anterior are seen to bridge over, generally at three or four points simul-