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The average weight of the normal liver is from 50 to 55 ounces, but as noted by Powell, it may become so hypertrophic as to weigh as much as 40 pounds. Bonet describes a liver weighing 18 pounds; and in his "Medical and Surgical Observations," Gooch speaks of a liver weighing 28 pounds.
The cases studied by Virchow were diffuse hyperostoses of the cranium. Starr describes what he supposes to be a case of this disease, and proposes the title megalocephaly as preferable to Virchow's term, because the soft parts are also included in the hypertrophic process.
The author excludes syphilis, tuberculosis, rheumatism, gout, hemophilia, etc., and considers it to have been a trophic affection of cerebral origin. Cases of pneumonia osteoarthropathy simulating acromegaly have been reported by Korn and Murray. Megalocephaly, or as it was called by Virchow, leontiasis ossea, is due to a hypertrophic process in the bones of the cranium.
In chronic tendinitis there occurs repeated attacks of inflammation wherein lameness is pronounced and there exists in reality, at such times, acute inflammation of a hypertrophic structure, where at no time does inflammation completely subside.
"Apoplexy and palsy, in a scarcely credible number of cases, are directly dependent on hypertrophic enlargement of the heart." And in other cases, asthma, dropsy, and epilepsy are caused.
If we can relax this exaggerated state of nervous tension, if we can help them to become fatter and to put on weight, the dyspepsia will disappear with the other symptoms. It is a question still to be answered whether the rare conditions of pyloric spasm and pyloric hypertrophic stenosis are not further developments of the same disturbance.
That ligamentous injuries owing to sprain frequently occur and attendant periarticular inflammations with subsequent hypertrophic changes follow, is a logical inference. Fibrillary fracture of the collateral ligaments may take place in falls or when animals make violent efforts to maintain their footing on slippery streets.
General dropsy, elephantiasis, lipomata, myxedema, and various other affections in which there is a hypertrophic change of the connective tissues may be mistaken for general obesity; on the other hand, a fatty, pendulous abdomen may simulate the appearances of pregnancy or even of ovarian cyst.
It may be months or even years before the lipping and other hypertrophic changes in the ends of the bones are recognisable, and before the joint assumes the deformed features which the name of the disease suggests. The capsular ligament, except in hydrops, is the seat of connective-tissue overgrowth, and tends to become contracted and rigid.
Finally, also, it provokes that hypertrophic modern State constitution of the South and West, which tries to bind down future legislatures in infinite particulars, thereby again diminishing their importance and responsibility, making it more difficult to get able men to serve in them, and, by the frequent necessary amendment of State constitutions, resulting in a continual referendum, which nearly does away with representative government itself.
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