812 PETEK BASSOE 



(1913). The conditions may even approach the "hypophyseal cachexia" 

 described by Simmonds(5) in connection with destructive lesions of the 

 gland such*as embolic softening following childbirth, metastatic carcinoma, 

 and tuberculosis. It is characterized by premature senility, general ca- 

 chexia, loss of pubic and 'axillary hair, dry, thin, wrinkled skin (Reiche; 

 Schlagenhauf er ; Bostroem). In an old case of acromegaly in a man of 

 61 years reported by Dunn obesity and increased sugar tolerance developed, 

 and also the rare complications of transient edema of the eyelids and 

 transient hemoptysis, the latter ascribed to hemorrhagic edema of the 

 lungs. 



Congenital Acromegaly 



Marie defined the disease as "non-congenital," and as yet no certain 

 case of congenital acromegaly has been reported. Sometimes a baby pre- 

 sents a multitude of deformities which may be so combined as to pro- 

 duce a resemblance to acromegaly. Such a case is reported by Schmincke 

 who, however, does not consider it one of acromegaly. This baby was 76 

 cm. long at death at 14 months. The hands and feet, fingers and toes, 

 were abnormally long; kyphoscoliosis was present. The hypophysis was 

 placed deeply in the sella and somewhat flattened but it was normal his- 

 tologically. Tower skull, talipes, dislocated lenses and other deformities 

 were present. The only case which seriously suggests congenital acro- 

 megaly is the following which fortunately has been very well described : 



Salle's much discussed case is that of a male child first examined 

 when one day old, when his length was 56 cm., and weight 3125 gm. The 

 circumference of the head was 35 cm. The face was coarse and wrinkled 

 with very large nose and prominent chin. The tongue was very large. A 

 congenital heart lesion was present. The arms and legs were relatively a 

 little longer than normal while the hands and feet were of entirely dis- 

 proportionate length. The hands were 7.5 cm. long, the feet 10.6 cm. The 

 middle fingers measured 4.5 cm. and the big toes 3.4 cm. The extremities 

 were not thickened but on the contrary very slender. On rontgenologic 

 examination the chief differences from the appearance of a normal child 

 of the same age wore the complete development of the center of ossification 

 in the terminal phalanx of the little toe while that of the cuboid was lack- 

 ing. The Wassermann test was negative and there was no clinical evidence 

 of syphilis. The child had much digestive disturbance and cyanosis and 

 died at the age of 2!/> months. The body was poorly nourished; length 

 59 cm. The feet measured 10.8 cm. and the middle fingers 4.75 cm. The 

 most striking postmortem finding was a decided widening of the sella tur- 

 cica. The hypophysis was pressed against the back of the sella by a bean- 

 sized growth of bony hardness. The brain was of normal appearance. 

 There was no definite histologic change in the hypophysis although the 



