306 PETEE BASSOE 



contained an account of 38 cases. In 1891 Duchesneau added 28, and in 

 1892 Collins brought the number up to 83. l The old medical literature 

 was ransacked, and old paintings and sculpture scrutinized. Apparently 

 the oldest find was that by Sternberg of a life size portrait dated 1553 in a 

 castle in Tyrol of a "giant" at the court of Frederick II, elector of the 

 Palatinate, showing the typical features of acromegaly. The oldest med- 

 ical description appears to be one by Saucerotte in 1772, to whom also is to 

 be credited the first museum specimens of acromegalic bones which he 

 secured from the grave of his patient. They are preserved in the Musee 

 Dupuytren in Paris. In 1839 Magendie gave a vivid description of two 

 women under his care in the Hotel Dieu in Paris. 2 The skeletal changes 

 had been described in detail by Langer in 1872. He noted the huge lower 

 jaw, the large sinuses, the bony enlargement at the points of muscular 

 attachment and from the enlargement of the sella turcica he inferred that 

 the hypophysis had been diseased. In Italy, Vergo in 1864 gave the post- 

 mortem findings, which included enlarged sella and tumor of hypophysis, 

 in a case which he recorded as an instance of "prosopectasia," a term also 

 used by Taruffi (1879), who described an acromegalic skeleton in the mu- 

 seum at Bologna. Brigidi (1887) described the postmortem findings in an 

 Italian actor with "strange deformities/' and, according to Sternberg, 

 gave the first histologic description of the hypophysis tumor in acromegaly. 

 Both Taruffi's and Brigidi's cases are accepted as typical instances of 

 acromegaly in the thesis of Souza-Leite. In England, Cunningham (1879) 

 described an undoubted case of acromegaly and diabetes; the skeleton of 

 the patient was preserved and described, in the light of Marie's announce- 

 ment, by Thomson in 1890. In Germany, Fritsche and Klebs in a mono- 

 graph published in 1884 gave an excellent description of the acromegalic 

 giant, Peter Rhyner, and in France, Henrot, in 1877, had described a 

 case which he considered one of myxedema. 



In view of such a large number of early cases the failure to correlate 

 them prior to 1886 is only explainable by their having been reported from 

 widely separated localities, under very varied titles, and partly in obscure 

 publications. Since the earlier collective reviews previously mentioned, 

 the literature on acromegaly has grown tremendously. An excellent col- 

 lective review by Sternberg(a) appeared in 1897. The most important re- 



1 A11 references to and including 1898 are found in the exhaustive articles by 

 Harlow Brooks and Hinsdale. The first case reported in America was that of a woman 

 presented before the New York County Medical Association on October 15, 1888, by 

 Isaac Adler and described by him in greater detail the following year. The necropsy 

 report of this case is found in the article of Brooks ten years later. J. T. O'Connor 

 also reported a case in 1888. 



2 "One is a real female monster. Head, extremities, trunk, all are of enormous 

 volume. Her tongue is broad like that of a calf, her fingers as wide as four of mine. 

 Her voice is like a man's, full and deep; I do not doubt that her larynx also is hyper - 

 trophied. The other woman is similar, but on a smaller scale. Being younger, and 

 growing more rapidly from day to day, I do not doubt that she will soon rival her 

 senior. Nothing explains the enormous growth in these two women." 



