180 ENDOCRINE GLANDS 



mind and in body. Their mentality is very inferior and 

 they are nearly always impotent and sterile. 



CLINICAL FORMS. 



Gigantism can be divided into two definite types, be- 

 tween which, however, there are many intermediary forms. 



1. GIGANTISM WITH ACROMEGALIA is characterized by 

 a marked deformity of the spine, so that the inferior por- 

 tion of the body seems to telescope in the superior segment 

 while the trunk is wider. These individuals resemble 

 anthropoid apes and also show typical signs of acromegalia, 

 the face elongates, the cheek bones are prominent, the 

 nose increases in size, the chin protrudes forward and the 

 hands and legs become enormous. The hypertrophy of the 

 extremities differs slightly from that of typical acromegalia. 

 The fingers have not the sausage shape, for the development 

 is more in length than in width. (Pierre Marie). 



2. INFANTILE GIGANTISM is characterized by elonga- 

 tion of the inferior extremities, accompanied by genu 

 valgum. The head and body extremities remain normal 

 without any deformities. 



To these skeletal signs are added signs of infantilism; 

 the genital organs keep the same size they had in childhood. 

 Hairs do not appear as normally; the voice remains frail 

 and childish. Some have even a feminine form; the breast 

 slightly developed, the abdomen rounded, the pelvis broad. 

 Finally, in these giants, the cartilages persist in the adult 

 and the epiphysis do not fuse with the diaphysis. 



Even in these cases of infantile gigantism at any time 

 may appear signs of acromegalia. The two types may 

 combine and gigantic infantilism gradually changes to 

 acromegalia gigantism. 



3. GIGANTISM is said to be sometimes found. The 

 exaggerated development of the skeleton in those cases is 



