PATHOLOGICAL ANATOMY OF THE HYPOPHYSIS 279 



ences of the elbows about 27 cm., the middle finger about u cm. long, the 

 thumbs 7-7^ cm., the circumference of the knee 40-41 cm., the length of 

 the feet about 31 cm., the left leg weighed 4.85 kg., the right 5.1 kg. With all 

 this the total height of the body was not very great (172 cm.). The body 

 weight was 50 kg. The head was small, only the nose and the tabular part 

 of the occipital bone were somewhat larger; the teeth, especially the upper 

 incisors, were strikingly large. The dimensions were eunuchoid (lower 

 length 112 cm.), the genital organs were entirely infantile (penis 5 cm.), 

 the secondary sexual characters were not developed. X-ray examination 

 showed that the sella turcica was widened, and that only the body parts of 

 the extremities were so considerably enlarged. From youth on there had 

 existed pains of a lancinating character; lately there were very profuse 

 sweats, great muscular weakness, and sensitiveness of the periosteum of 

 the long bones to pressure. It is further noteworthy that veins of the en- 

 larged parts were markedly dilated. A nearly analogous case was recently 

 observed in the Hochenegg clinic and was exhibited by Demmer before the 

 Gesellschaft der Arzte in Vienna [Vienna Medical Society]. Pel termed 

 this case "acromegalie partielle avec infantilisme." 



Another type is described by Babonneix. The case was that-of a seventeen- 

 year-old epileptic, 174 cm. tall, two years ago gradual beginning of abnormal 

 growth of the extremities. The hands became strikingly 'long, the feet 

 "laughably" voluminous, this together with alteration of the disposition, 

 polyphagia and polydipsia; pubic hairs sufficiently developed, genitalia 

 strikingly well developed, especially the penis and testicles, the frontal 

 sinuses remarkably large, eye-grounds normal, sella turcica not enlarged. 

 Babonneix speaks of an acromegaliform syndrome. A similar case was 

 exhibited by Mosse before the Societe de neurologic of Paris in May, 1911. 



Still another type is described by Renon and Delille. A sixteen-and-one- 

 half-year-old girl, who was normal up to the sixteenth year of life, became 

 affected with eye-disturbances, headaches and backaches with vomiting, 

 increased growth. Now 168 cm. tall (lower length 103 cm., span width 180 

 cm.) outbreaks of sweat, obesity especially in the loins and on the abdomen, 

 breasts poorly developed (fat is painful). Slight hairiness of the pubic 

 region and axillae. Has not as yet menstruated, sella turcica much enlarged, 

 optic atrophy. The authors regard this case as a polyglandular disturbance. 



Finally there are reports as to the occurrence of acromegaly in early 

 childhood. Salle reports the following: The nose of a new-born infant was 

 strikingly large, the chin prominent, the auricles large, flap-like, the tongue 

 large. The relation of the extremities and of the head to the total length was 

 that of a two-year-old child. Hands and feet especially large, fingers and toes 

 strikingly large. Ossification corresponds to that of a three- to four-year-old 

 child. The child died at the age of two and one-half months. The sella 

 turcica was very large, the hypophysis was deformed in the shape of a bean 



