GIGANTISM 809 



1. Acromegalic giants about 40 per cent of the total. 



2. Cases with multiple tumor-like exostoses (leontiasis ossea 

 and hyperostoses). 



3. Cases with facial hemihypertrophy. 



4. Cases with multiple curvature of the bones of rhachitic 

 character. 



5. Gigantism in hereditary syphilis. 



6. Gigantism in connection with testicular tumors in children. 



This was the best classification possible on the basis of the data available 

 at that time but it is obviously superficial and merely an index of cer- 

 tain features which had been emphasized by the respective authors. 



Gigantism with Infantilism 



Characteristics of Infantilism, Infantilism is discussed in another 

 chapter, but for purposes of orientation the salient features may be 

 reviewed here. Meige defines infantilism as "a developmental anomaly 

 characterized by the persistence in a person past the age of puberty of 

 morphologic features belonging to childhood." 3 The most important 

 of these features as a determining factor in giant growth is delayed union 

 of the epiphyseal cartilages beyond the normal age. The genital organs, 

 external and internal, are more or less rudimentary and functionally use- 

 less. The menses do not appear. The secondary sexual characteristics, 

 such as beard, pubic and axillary hair, adult voice, etc., are not attained. 

 It must, however, be emphasized that stunting of growth need not be 

 a feature. Infantilism is a condition entirely apart from dwarfism. 

 Either may exist without the other though they may be combined. 

 Typical infantilism is seen in people of normal size as well as in giants 

 and dwarfs. 



Hypophyseal Infantilism. That infantilism may primarily depend 

 upon hypophyseal deficiency in the absence of thyroid defect is stoutly 

 maintained by A. Souques and S. Chauvet. The genital hypoplasia is 

 considered secondary. Several cases have been examined post mortem 

 and the hypophyseal lesion confirmed. Cushing prophesies that ulti- 

 mately all cases of hypophyseal infantilism will come to be grouped to- 

 gether whether they exhibit adiposity or not. 



The Influence of the Gonads on Growth. In the search for under- 

 standing of gigantism and dwarfism in connection with infantilism it 

 is incumbent on us to consider the possible effect upon growth of the 

 deficiency of the sexual glands per se. The effects of castration are 

 particularly suggestive. Like capons, eunuchs are prone to be of large 



8 The term infantilism was first used in the present sense by Lasegue. 



