56 FIELDING H. GARRISON 



have said, regarded as an abnormity from the days of Goliath of Gath up 

 to the time of tTohn Hunter's famous and expensive chase after the skele- 

 ton of the Irish giant (1783) ; but even before this latter, definite cases 

 had been reported, with good accounts of the deformities of the bones and 

 the periodic coma, by Saucerotte (1772) and Noel (1779), and in the 

 nineteenth century others were added by Alibert (1822), by Chalk (1857), 

 by Friedreich in the case of the two Hagner brothers (1868), by Lom- 

 broso (1868), and by Sir Samuel Wilks, who in 1869 made a striking 

 notation of the disease. The accepted classical account is that of Char- 

 cot's pupil, Pierre Marie, who differentiated the affection from myxedema, 

 osteitis deformans, and leontiasis ossea, gave it its present name, and, four 

 years later, correlated it with disease of the pituitary body. Marie's 

 account was preceded by cases in which a, lesion of the pituitary body in 

 acromegaly had already been noted by Verga (1864), Brigidi (1877), 

 and more particularly in the superb autopsy made by the late Edwin Klebs 

 in 1884, which is the work of a veteran pathologist. This monograph, 

 based upon a case furnished by Dr. Fritsche, of Glarus, Switzerland, con- 

 tains two striking views of the patient and a remarkable diagram of the 

 acromegalic skull ; the hypertrophy of the pituitary body and the conse- 

 quent widening of the sella turcica is strongly emphasized. But the opin- 

 ion of the eminent pathologist is divided between this lesion and a prolif- 

 eration of the thymus gland, which he found in the same autopsy, and 

 after balancing the claims of the two lesions at length, he winds up by de- 

 claring that the cause of the disease must remain obscure. The view of 

 Marie, which connects it directly with a lesion of the pituitary body, 3 has 

 been, with some reservations, the theory accepted up to the present hour. 

 It is interesting to note that, from the time of Galen up to the seventeenth 

 century, the pituitary body was held to be the source of the mucous dis- 

 charges of the nose. Vesalius, for this reason, called it the "glans pituitam 

 excipiens." This idea was overthrown in Conrad Victor Schneider's 

 treatise on the membranes of the nose ("De catarrhis," 1660) and by 

 Richard Lower in HJ72. 4 Tlieophile de Bordeu, in his anatomical re- 

 searches, states that the ancients thought the office of the pituitary body 

 was to empty its humors through the nostrils, the moderns holding that it 

 sent them to the sinuses of the sella turcica, and there the matter ends with 

 him, although he indulges a few vague conjectures as to the possibility of 

 the passage of the pituitary secretions into the circulation. 



3 For an interesting account of tins disease, see "Acromegaly, A Personal Experi 

 "nee" (London, 1012), by Leonard Portal Mark, a 



given a graphic and pathetic description of the gradual onset of the distressing malady 

 \vn body. Although his disease was privately diagnosed by most of his clinical 

 H and he was "spotted" as an acromegalic in a Parisian crowd by Marie him- 

 If, Dr. Mark did not begin to realize his condition until he was fifty. 



work of Schneider and Lower did away with the innumerable recipes for 

 sing the brain" of these alleged pituitary humors. 





