ACROMEGALY 



807 



cent single contributions are found in the monographs on the hypophysis 

 by Cushing(fr) and by Blair Bell (5), and in the text books on the organs of 

 internal secretion by Falta(c) and by Biedl(fc). A unique contribution 

 is the self -description by Dr. Mark, an English physician and a victim of 

 the disease. He relates the subjective symptoms and mental attitude of the 

 patient in a delightful manner and with a vividness possible only from 

 one with personal experience and possessed of medical acumen. 



Etiology 



The disease occurs in all races and climates. The sexes are about 

 equally affected, the female possibly predominating slightly (Leri, Bell). 

 Of 210 cases collected by Sternberg, 104 were in men and 100 in women, 

 while of Hinsdale's 130 cases the numbers were, respectively, 73 and 57. 

 The age at the onset, in the ma- 

 jority of cases, is between 20 

 and 30 years ; in a fair number 

 between 30 and 40, and in a 

 few instances between 15 and 

 20 and after 40. Onset in child- 

 hood or evidence of the disease 

 at birth is exceptional and the 

 cases reported are largely de- 

 batable. They will be analyzed 

 on a subsequent page where it 

 will be shown that most of them 

 are complicated by other endo- 

 crin affections or by congenital 

 syphilis. 



a. Heredity. H e r e d i t y 

 plays no important role though 

 it has been recorded in a few 

 instances. Fraenkel, Stadel- 

 mann and Benda report a case 

 of typical acromegaly in a man 

 whose brother probably had the 

 same disease, and the father 

 and a sister are said to have had 

 similar deformities of the face 



and extremities. Bonardi reports acromegaly in father and son; 

 Franchini and Giglioli in father and daughter. Schwoner and Frantzel 

 each report cases in mother and daughter but only on hearsay- 

 evidence in the case of the daughters, and even the mother in Frantzel's 



ter. 



Fig. 1. Acromegaly in father and daugh- 

 ( Franchini and Giglioli.) 



