456 PLURIGLANDULAR DISEASES 



to the purpose to adduce examples of the various types from the literature, 

 whereby I would mention that all possible transitions between the groups 

 occur. 



I will not enter further into the subject of normal giants. In the historical 

 introduction I have already mentioned the most important facts. 



Of the eunuchoid giants I mention the twenty-seven-year-old man 

 described by Launois and Roy. (Soc. de Biol., 10 Jan., v., 1903.) In this 

 individual the increased growth in height apparently began after an attack 

 of typhoid fever. 



I shall now adduce a series of cases relating to acromegalic giants, in 

 whom the function of the sexual glands was normal. As the first example I 

 communicate a case that I myself had occasion to investigate. 



Observation LV. B. O., "Bulgarian giant," born in Gross- Wenkheim near Bad 

 Kissingen, thirty-seven years old. The male members of the family are almost all 

 rather tall. The tallest was his father's brother, who measured 186 cm. His father 

 measures 180 cm. B. O. states that he first began to exceed his school companions in 

 growth at the seventh year of life. At twelve years of age he measured about 206 cm., 

 and at twenty-four years of age had attained his full height (212.5 cm.). He served in the 

 "Bayerischer Leibregiment" and was at that time examined by the chief physician, Dr. 

 Seggel. At that time he was entirely well, and had grown completely used to the military 

 service. He says that as a young man he weighed 145 kg. Especially in his eighteenth 

 to nineteenth years had his appetite become enormous. He says that it was easy for him 

 to devour at one meal i kg. of meat with copious additional fare. The highest weight was 

 195 kg. He had never suffered from headache. According to his statement the sexual 

 development was entirely normal. In 1900 he married a woman who was 187 cm. tall. 

 After one year she bote an entirely normally carried child, who died after four weeks. 

 Then later the woman had two premature deliveries, about in the fifth month. The 

 potency up to this time had, according to his statement, not diminished. Six years ago 

 he suffered from influenza and since that time "has had to do with a cough." The apex 

 of the right lung is defective. 



The man now measures 210 cm. as a distinct kyphosis exists, it is very probable that 

 his statement that he formerly measured 212.5 cm - is perfectly correct. The span width 

 reaches 220 cm., the breadth of the shoulders 52 cm., the circumference of the chest 118 

 cm., of the waist 100 cm. Distance from the anterior superior iliac spine to the floor 

 124 cm. 



There exists, as already mentioned, distinct kyphosis, the enormous shoulder blades 

 project prominently. The clavicles are enormously developed. The circumference of the 

 upper arm measures 29 cm., formerly when the patient was very muscular it reached 

 68 (?) cm. 



The distance of the external malleolus of the wrist-joint to the point of the middle 

 finger is 27 cm. 



The greatest circumference of the hand is 30.5 cm. The greatest circumference over 

 the metacarpopharyngeal joint is 27 cm. 



The middle finger, from the metacarpopharyngeal joint to the point of the finger is 14 

 cm., the circumference of the thumb 9 cm. 



Distance between the anterior superior spine and the upper border of the patella is 

 57 cm.; length of foot 33.5 cm. Circumference around the ankle-joint and heel 43 cm.; 

 length of great toe 9.5 cm.; circumference of the same n cm. The head is enormous. 



