GIGANTISM 459 



held responsible for only a small portion of the decay. Signs of increased 

 intracranial pressure are not as yet present in this patient; with which the 

 X-ray findings- these show especially a deepening of the floor of the sella, 

 are in accord. Especially important in this case is the behavior of the 

 sexual glands. The functions of the genitalia up to the present time have 

 been entirely normal. At all events up to his thirtieth year the patient 

 was capable of reproduction. At most we could say that the early death of 

 the first child and the two following premature deliveries on the part of his 

 wife point to a diminished valuation of the semen, but this assumption does 

 not seem to me to be well considered. In agreement with the sexual po- 

 tency we find the dimensions of the skeleton normal, and the hairiness even 

 abnormally strongly developed. 



Also the giant of Hue hard and Launois had two children. In this case 

 the abnormal increase in growth began in the twelfth year of life. At the 

 age of eighteen he was 197 cm. tall. The genitalia were entirely normally 

 developed. He attained the age of sixty years and at that time showed typical 

 acromegalic manifestations. The sella turcica was the size of a nut. Sclero- 

 sis of the anterior lobe was found at autopsy. This case has been brought 

 forward as a demonstration against the hyperfunction theory of acromegaly. 

 Incorrectly however, for we may well imagine that in late life the acromegalic 

 manifestations must not necessarily retrogress when there occurs without any- 

 thing else a secondary sclerosis of the hypophysis. 



The case c-f Buday and Jancso showed an abnormal increase of the 

 potency that was at all events short in duration. At seventeen years of 

 age this patient was very potent, and performed coitus four to six times 

 every night. From the twentieth year on he gradually became impotent. 

 It is noteworthy that this case was only 103 cm. tall when he was twenty 

 years old. Now he first began to grow appreciably, and at the age of thirty- 

 five years had attained the height of 198 cm. He now showed distinct 

 acromegalic symptoms; there was found a large tumor of the hypophysis, 

 the genitalia were atrophied, the length of the lower part of the body was 

 very considerable, there existed a genu valgum, the epiphysial junctures 

 were ossified (the abnormal growth has ceased for two years). In this case 

 we have the sort of late eunuchoidism combined with acromegaly. It is 

 very noticeable that in spite of the increased sexual function, the epiphysial 

 junctures remained open between the seventeenth and twentieth years. 



I would regard the case described by Gushing as one in which the late 

 eunuchoidism began later. This thirty-five-year-old patient came from a 

 healthy family. The father was six feet tall. At the age of thirteen years 

 the patient first began to grow enormously rapidly; at the age of nineteen 

 years he was 6 ft. 4 in. tall, weighed 200 Ib. and was of extraordinary strength 

 and he was intelligent, a good student, and "aside from an uncontrolled 

 libido sexualis" had good manners. Especially noteworthy seems to me 



