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Hypertrophy of the digits is the result of many different processes, and true hypertrophy or gigantism must be differentiated from acromegaly, elephantiasis, leontiasis, and arthritis deformans, for which distinction the reader is referred to an article by Park.
Its enlargement is attended by giantism and another curious giant disease in which the hands, feet, and jaws enlarge enormously, known as acromegaly. It also pours into the blood a secretion which has a powerful effect upon both the circulation and the respiration. It is found shrunken and wasted in dwarfs. Some years ago it was suggested by my distinguished friend, the late Dr.
Mantegazza refers to a strong sexual temperament as being associated with arrest or disorder of bony development, and Marro suggests that the proverbial salacity of rachitic individuals may be due to an increased activity of the sexual organs. It may be added that acromegaly, with its excessive bony growths, tends to be associated with premature sexual involution.
But if he chances to suffer from some rare and choice disease, such as Trypanosomiasis or Acromegaly, the doctor will be delighted to listen." "Then are we to understand," Miss Bellingham asked, "that we are rare and choice products, in a legal sense?" "Undoubtedly," replied Thorndyke. "The case of John Bellingham is, in many respects, unique.
Acromegaly is distinguished from osteitis deformans in that it is limited to hypertrophy of the hands, feet, and face, and it usually begins earlier. In gigantism the so-called "giant growth of bones" is often congenital in character, and is unaccompanied by inflammatory symptoms. The deformities of the articulations may be congenital but in most cases are acquired.
Early in this century Rayer described a case of elephantiasis in a boy of seventeen who, after several attacks of erysipelas, showed marked diminution of the elephantoid change; the fact shows the antagonism of the streptococcus erysipelatis to hypertrophic and malignant processes. Acromegaly is a term introduced by Marie, and signifies large extremities.
Mentally he was dull; the bones of the face and extremities showed the hypertrophies characteristic of acromegaly, the soft parts not being involved. The circumference of the trunk at the nipples was 62 inches, and over the most prominent portion of the kyphosis and pigeon-breast, 74 inches.
Numerous telangiectatic spots were scattered irregularly over the body, but most thickly on the right side, especially on the outer surface of the leg. The accompanying illustration represents the child's appearance at the time of report. At first this case was erroneously diagnosed as acromegaly. The hypertrophy affected the face, the genitals, the left side of the trunk, and all the limbs.
The nose is large and broad, and the skin of the eyelids and ears is enormously hypertrophied. The tongue is greatly hypertrophied. The disease is of long duration, and late in the history the bones of the spine and thorax may acquire great deformity. As we know little of the influences and sources governing nutrition, the pathology and etiology of acromegaly are obscure.
In the disease called acromegaly, which is due to a change in the pituitary gland, amongst other things are noted "melancholic tendencies, loss of memory and mental and physical torpor." A very profound effect on character and personality, exclusive of intelligence, is that of the sex glands.