808 PETEE BASSOE 



For practical purposes we may distinguish the following epochs in the 

 evolution of the study, of gigantism. 



1. The period of myths and legends. 



2. The historic period up to the time of Darwin and Virchow, or 

 the middle of last century. Very little precise information was re- 

 corded. 



3. The anatomic and anthropologic period from the middle of the 

 last century until the description of acromegaly hy Pierre Marie in 

 1886. Many giants were well described and subjected to postmortem 

 examinations. Minute measurements of living patients and of skeletons 

 were recorded but the cases were regarded as anatomic curiosities and 

 no true clinical conceptions were elaborated. 



4. A very active period of investigation, revision and contention 

 which followed the prompt recognition of acromegalic features in many 

 living giants and skeletons of giants (approximately 1890-1905). There 

 was a lively exchange of views between those who favored the idea of 

 the essential identity of acromegaly and gigantism (at first chiefly 

 Italian investigators), and those principal among them Marie himself 

 who considered the two diseases, distinct entities which only occasion- 

 ally coincided. 



5. The present period, inaugurated by the fundamental investiga- 

 tions of Brissaud, Meige, Woods Hutchinson, and Launois and Roy, 

 which were carried on for some years preceding the appearance of 

 the first exhaustive monograph on the subject by the last named authors 

 in 1904. The facts so ably compiled in this work, and subsequent ob- 

 servations, among which perhaps the most interesting and convincing 

 are those of Harvey Gushing (c), have clearly established gigantism as a 

 disorder related to disturbed endocrin function, the hypophysis playing 

 the most important, but by no means the entire role. 



Classification. It is noteworthy that almost all giants described in 

 the last twenty years, the period during which consideration has been 

 given to endocrin disorders, fall in one of the following groups : 



1. Gigantism with infantilism. 



2. Gigantism with acromegaly. 



3. Gigantism with infantilism and acromegaly. 



In the earlier reports attention had been paid chiefly to the skeletal 

 changes, which usually had been minutely described, while the hypophysis 

 frequently was not mentioned at all, as in the case of Buhl's otherwise 

 excellent description of the famous giant Thomas Hasler. In 1897 Maxi- 

 milian Sternberg gave an excellent resume of the status of the giant 

 problem. He recognized the existence of "normal" giants, among whom 

 he placed Virchow's case, Winkelmeyer, 227.8 cm. tall. His classifica- 

 tion of "pathological" giants was as follows: 



