There are individuals who go about outside of hospital walls, quasi-normally, who are semi-hibernators or partial hibernators, and who are really in a state of subpituitarism.  They are people who may have something wrong or inferior with their pituitary, but not to the extent of interference with their daily life.  They go about with their type stamped upon them for the seeing eye.  The classical type is obese, with fat distributed everywhere, but more so in the lower abdomen and the lower extremities.  They are slow and dull, and sexually inactive, often impotent.  They are sometimes tall, but most often dwarfish, and may be subject to epileptic seizures.  They recall the picture of what happens to young dogs partially deprived of the pituitary.  Dickens delivered a perfect likeness of an extreme degree of the condition in the Fat Boy of the “Pickwick Papers,” whose employment with Mr. Wardle consisted in alternate sleeping and eating.

WHEN THE PITUITARY OVERACTS

All grades of overaction of the pituitary exist.  Then its peculiar power to act as a stimulant to the growth of bone and the soft supporting and connecting tissues like tendons and ligaments comes into play.  If the overaction or excess of secretion begins in childhood or adolescence, that is, before puberty, there results a great elongation of the bones, so that a giant is the consequence.  Now giants have always appealed to the imagination of the little man, and have had all kinds of wonderful abilities ascribed to them by him.  The giants and ogres of folk-lore and fairy tales are favored with the most extraordinary mental advantages.  Direct and analytic acquaintance with the giants of our own day, as well as a probing of their conduct in the past, has shown that normal giants—­persons of exceptional size free from physical or mental deformities—­are rare.  There are people with hyper-pituitarism who exhibit the highest mental powers.  In them is an increased activity of the posterior lobe in association with enlargement and hyperfunction of the anterior, overgrowth is not so marked, and the individual is lean and mentally acute.  But the ordinary giant is one in whom there is degeneration of the pituitary after too much action of the anterior and too little of the posterior glands.  A tumor or disease process in the gland is most often responsible.

If the overaction of the anterior happens after puberty, when the long bones have set, and can not grow longer, a peculiar diffuse enlargement of the individual occurs, especially of his hands and feet and head.  The nose, ears, lips and eyes get larger and coarser.  As these people are rather big and tall to begin with, the effect produced is that of a heavy-jawed, burly, bulking person, with bushy overhanging eyebrows, and an aggressive manner.  For there is, too, something distinctive about their mentality which has been as often portrayed as those of the pathologic giant.