GIGANTISM 811 



1. The trunk is of nearly normal size and the excessive length 

 is in the extremities. 



2. The lower extremities are relatively longer than the upper. 



3. The proximal segments of the extremities (femur, humerus) 

 are relatively less increased in length than the distal segments. 



4. The hand and the foot are a little less increased in length 

 than the fingers and toes. 



Examples of Combined Gigantism and Infantilism 



1. The giant Charles, 30 years old, height 204 cm. (7 ft. 8 in.), 

 described by Launois and Roy, had weighed 21 Ihs. at birth (?), was 

 very tall at 12 years and measured 186 cm. at 21, 194 cm. at 24. His 

 upper and lower extremities were unduly long, and there was marked 

 genu valgum. The genitalia were poorly developed, the testicles rudi- 

 mentary, the prostate not felt on rectal examination. Sexual desire 

 and power were absent, There was neither beard nor axillary hair, and 

 very scant pubic hair. The hands and feet were disproportionately 

 large: not so the lower jaw. Rontgenologic examination showed that at 

 the age of 30 years his epiphyseal lines remained open. His intelli- 

 gence was fairly good but he was somewhat emotional and ill tempered. 



2. Bramwell describes a man, 50 years old, 6 feet 3% inches tall, 

 who began to grow rapidly at 20 years. The fingers were long and 

 tapering. The penis and testicles were very small; there was no beard, 

 axillary or pubic hair, and the voice was childish. He was deficient 

 mentally. The cause of cTeath was heart disease. Post mortem the 

 hypophysis was found not to be enlarged, and the thyroid was small. 



3. Jodiche's case is typical of this class and remarkable on account 

 of the family history. The father was 235 cm. tall and died at 55 

 years of carcinoma of the lung. The paternal grandfather was said to 

 have been a giant, and the father's younger brother was "very large." 

 There were three older brothers of the patient, measuring respectively 

 180, 185 and 184 cm. and an older sister 168 cm. The patient was 22 

 years old, measured 205 cm. and weighed 79 kilos. He had always been 

 large but grew very rapidly between the ages of ten and fourteen years, 

 He was of a. very low intelligence and energy, sluggish in everything 

 except eating in which he indulged to excess. His voice was that of a 

 child. The penis was of a size normal in a boy of five years, the testicles 

 and prostate very small. There had been no signs of genital function. 

 The thyroid was not enlarged. There was no growth of hair on the face, 

 pubes, or in the axillae. Further evidence of infantilism was revealed 

 by the open epiphyseal lines in the hands. The thyroid was palpable. 

 The bones were delicate, the arms and legs were very long, and hands 



