Historical Perspective

Abstract

The initial stimulus for the study of the role of the anterior pituitary gland in the regulation of growth arose from clinical observations. Marie is generally given the credit for characterizing and naming the syndrome of acromegaly in his 1886 paper (1). In a review only 3 yr later (2) he described one characteristic of the pathologic anatomy as “hypertrophy of the pituitary body with enormous dilatation of the sella turcica.” However, pituitary tumor and sellar enlargement were not always present, and there were various theories on the possible relationship of pituitary abnormalities to the growth disturbance. Harvey Cushing of Johns Hopkins Medical School introduced the terms hyperpituitarism and hypopituitarism, and in 1912 he championed the “hyperpituitarism conception of acromegaly” in his monograph on the pituitary (3). The argument was based on a review of the literature and his own extensive clinical, pathological, and experimental observations. He concluded, “Certainly most of the circumstantial evidence in our possession points in the direction of an oversecretion, whether normal or pathological....” He added, “One point at least is now generally accepted, namely, that the skeletal changes in gigantism and acromegaly are expressions of the same morbid influence....”