Acromegaly 



PETEE BASSOE 



CHICAGO 



Definition and Clinical Conception of 

 Acromegaly 



The term acromegaly was constructed by Pierre Marie(a.) in 1886 to 

 designate "a peculiar, non- congenital hypertrophy of the upper, lower, and 

 cephalic extremities." It literally means "large ends." Marie's concep- 

 tion was purely morphological and based on external appearances. At the 

 time of his first formulation of this morbid entity he felt that it was one 

 he did not know its relation to the hypophysis, or the tremendous impe- 

 tus its study was to give to pathology, especially to research directed to the 

 ductless glands and the skeleton. Minkowski, in 1887, was the first to 

 suggest the probable role of the hypophysis but many years elapsed before 

 there was any clearness as to how this role is played. According to our 

 modern conception acromegaly is a morbid state caused by glandular hyper- 

 plasia- and functional overactivity of the hypophysis, resulting in: (a) pi*ir 

 mary glandular symptoms consisting mainly of abnormal growth of the soft 

 and bony parts of the "end segments" tongue, jaw, hands and feet; 

 (&) secondary glandular symptoms from associated and subordinate dis- 

 turbances of other endocrin glands, notably of the gonads, the adrenals 

 and the thyroid; (c) local mechanical pressure symptoms caused by the 

 hypophyseal tumor and affecting chiefly the optic chiasma and nerves; 

 (d) secondary and general brain symptoms dependent on increased in- 

 tracranial pressure. 



History of the Development of the Conception of 



Acromegaly 



Marie's announcement in 1886 met with immediate approval and a 

 spontaneous response from medical investigators everywhere. His de- 

 scription was based on two personal cases and a few selected from the lit- 

 erature, previously described under various titles. Cases multiplied with 

 marvelous rapidity. The thesis by Marie's pupil, Souza Leite, in 1890, 



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