816 PETEK BASSOE 



dinary length of the lower extremities, whose genitalia, however, were of 

 the size normal in a boy of six years. Wieting describes a case of 

 eunuchoid or infantile gigantism in a congenitally syphilitic boy of 18 

 years, 225 cm. tall, with kyphosis and genu valgum, but proportionate 

 extremities. 



Gigantism with Acromegaly 



Only a few years after Marie's fundamental work on acromegaly, 

 attention was called by many observers to the relationship between this 

 disease and gigantism. In 1889 Virchow (b) recognized a certain similar- 

 ity between those two conditions but not any kinship. In 1892 Massalongo 

 stated that acromegaly is nothing but delayed, abnormal gigantism. The 

 identity of the two disorders was further advocated by Brissaud and 

 Meige (a) (1895) and Woods Hutchinson (b) (1898). The latter sum- 

 marized his conclusions as follows : "1. The greater part of the overgrowth 

 is found at or near the tips of the segment-crescents, as in acromegaly, dif- 

 fering from the latter mainly in that it is not exclusively confined to the 

 tip of the segment or last division of the limb. 2. The facial part of 

 the skull is enlarged out of all proportion to the cranial, particularly in 

 the region of the lower jaw. 3. The condition, whether it be regarded 

 as normal or morbid, is one that distinctly tends to shortness of life, 

 and would appear to have an average duration of scarcely more than 

 twenty years. 4. The mental and physical vigor of the giant is dis- 

 tinctly below par, and his death usually comes either from a steady, 

 progressive increase of this weakness, or from some trifling accident, or 

 usually mild, intercurrent disease. 5. Sexual powers appear in the 

 great majority of cases to be far below normal. 6. There is a decided 

 preponderance of males among the victims of this condition. In all of 

 these statements there is a decided parallelism manifested between 

 gigantism and acromegaly. Last of all, and from the point of view of this 

 essay, of greatest interest is the fact that the one morbid condition which 

 is peculiar to both of these disturbances of nutrition, the enlargement 

 of the pituitary body, is found to be present in a large majority of cases 

 of both." After stating that, the material as yet is meager, he adds that 

 we are "justified at least in the tentative conclusion, until some evidence 

 to the contrary can be adduced, that acromegaly and gigantism are simply 

 different expressions of one and the same morbid condition ; in other words, 

 that acromegaly is a general overgrowth tendency which does, not, for 

 some reason, begin to express itself until after adult stature has been 

 reached, and which consequently expends itself upon those points in the 

 body at which growth last ceased the extremities of the segment-crescents 

 and the distal extremities of the appendages. Second, that gigantism in 

 a large majority of cases is this same condition manifesting itself in 



