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The pituitary is an oval glandular body composed of two lobes and a connecting area, which rest in the sella turcica, enveloped by a layer of tissue, about under this point." He indicated the red spot on her forehead as he spoke. "It is, as the early French surgeons called it, l'organe enigmatique. The ancients thought it discharged the pituita, or mucus, into the nose.
Always, in attempting to understand the pituitary, it is necessary to remember that it is tightly packed in the bony cradle, the Turkish Saddle or Sella Turcica. Should some stimulus, local, or in the blood, arouse the gland to growth, a good deal will depend upon whether it has room to grow in, or it will make room by eroding the bone.
All of them occur, for the developments of X-ray technique have rendered available almost a direct view of the sella turcica. In the first place, the bony box may be definitely too small to start in with.
There is also an old record of a ball lodging near the sella turcica for over a year, the patient dying suddenly of an entirely different accident. Fabricius Hildanus relates the history of an injury, in which, without causing any uncomfortable symptoms, a ball rested between the skull and dura for six months.
If the growth of the skull has left a roomy sella turcica for the pituitary to grow in, the intellect may be normal or even superior, though energy is below par. If this is not possible and the adrenals have to predominate, a lower, more animal and less self-controlled type of mentality is produced. In direct contrast to the subthyroid types is he who originally was hyperthyroid.
Yet out of the jumble of fragments, a fairly respectable insight has been gained in less than a half century. The pituitary is cradled in a niche at the base of the skull which, because of its form, is known as the Sella Turcica or Turkish saddle. So situated, an operative approach to it is overwhelmingly difficult. On the other hand, X-ray studies are favored.
At any rate, considered as checks to my interpretation, his physiognomy and physique, the nature of his genius and the attacks which finally ruined his life, all fit into the conception of him as one whose life centered, like Napoleon's, around what was happening in his sella turcica.
His first glance brought me over to him as he exclaimed loudly. At the point just opposite the sore which he had observed on Virginia's forehead, and overlying the sella turcica, there was a peculiar spot on the radiograph. "Something in that mask has affected the photographic plate," he explained, his face now animated.
But to one who had studied roentgenography as Kennedy had each minute gradation of light and shade had its meaning. "You see," pointed out Kennedy, tracing along one of the shadows with a fine-pointed pencil, and then along a corresponding position on another standard skiagraph which he already had, "there is a marked diminution in size of the sella turcica, as it is called.
At least they will, in their physiognomy, physique, mentality, conduct and character, document the glandular constellation under which they live, and a proper understanding of which is necessary for them to be helped. One frequently seen is the thymo-centric, with small enclosed sella turcica. The latter fact explains the occurrence of the epilepsy.
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