EXTRACT XLIII. 



ACROMEGALY. 



IT may be now conceded that the pathological conditions 

 representing the disease denominated acromegaly begin or 

 coincide with the development of minute and gross histo- 

 logical changes in the pituitary gland, or hypophysis, and 

 that, in fact, disease of that organ constitutes its starting 

 point : that being taken for granted, we may now enquire 

 how disease of the pituitary gland produces, throughout 

 the entire body structures, such unique changes and symp- 

 toms as are observed in acromegaly. It seems a "far cry" 

 to assign such changes as lengthening, thickening, consoli- 

 dation, and thinning, or attenuation, of the bones, wasting 

 of the muscles and hypertrophy of the skin, for example, 

 to the existence of disease in the hypophysis, but yet we 

 think we can, with the aid of the views we hold as to the 

 function, or functions, of that organ, trace, to an extent 

 hitherto impossible, the operation of physiological and 

 pathological factors in the process, which will entitle us 

 to describe it as one of cause and effect. Thus, regarding, 

 as we do, the pituitary body as a true gland, and assigning 

 to it the function mainly of dealing with, and excreting, 

 the more solid, as well as fluid, nervine and neuroglial 

 debris, which finds its way into the third ventricle of the 

 brain, in such a way as to clear it of these waste products, 

 which it does by a process of disintegration, liquefaction, 

 and excretion into the surrounding cavernous sinus of 

 the cephalic venous circulation, and also by the more direct 

 routes of the central and lateral cranio-pharyngeal 

 foramina, which are specially observable in embryonic or 



