CLINICAL APPLICATIONS OF STUDIES IN EXPERIMENTALLY INDUCED EXOPHTHALMOS OF ANTERIOR PITUITARY ORIGIN

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Abstract
Edema of the orbital tissues is the most likely of the various possible explanations for the mechanism of exophthalmos in Graves'' syndrome. The exophthalmos in Graves'' syndrome, like that of the guinea pig injected with an extract of the ant. pituitary, goes through 2 phases, viz., the reversible and the irreversible. The former is that commomly encountered in exophthalmic goiter; the latter infrequently occurs as a post-thyroidectomy complication of patients with this disease or rarely may actually precede the development of hyperthyroidism. An exophthalmos-producing (ophthalmo-trophic) factor in the pituitary, distinct from the thyrotrophic hormone, induces both types of exophthalmos. The nature of this pituitary activity is unknown. The use of the word ophthalmotrophic does not imply that a specific chemical substance is believed to exist as such in the pituitary gland. The fact that it probably is directly or indirectly responsible for edema of the orbital tissues suggests a correlation with the important role which the pituitary plays in regulating water metabolism. Certain circumstances which apparently predispose patients with exophthalmic goiter to the development of the irreversible type of orbital pathology are discussed.