ACROMEGALY 251 



of the gland organism, and to the system at large, which, 

 if not relieved or removed, must necessarily end in the 

 production of disease. This, to our mind, or in our 

 opinion, is just what does occur in the disease called 

 acromegaly, and the sequence of the accruing events may 

 be described as follows : a stasis, more or less complete, 

 occurs in the gland, beginning either in itself, on the one 

 hand, or in the infundibulum, or the other points of exit, 

 on the other, and which, if it persists, leads to a permanent 

 damming-back of the pituitary materials, and to their over- 

 flow into the various channels leading from the ventricle. 

 This overflow is followed by the invasion of the body 

 generally, but some parts in particular, by the pituitary 

 matter, along the lines of least resistance, or along the 

 lymph paths leading from, in the first place, the intra- 

 spaces of the brain and cord, and thence, from the sub- 

 arachnoid and sub-dural spaces, along the neurilemmar 

 inter-spaces of the nerves, sensory and motor, and, con- 

 sequently, into the tissue of the skin, the sheaths of the 

 muscles, and their individual fibres, to which they are 

 respectively distributed. Through its communicating 

 fibres, the invading material also reaches the sympathetic 

 system of nerves, and so also the parenchyma of every 

 organ and viscus, to which that system is attached, it also 

 reaches the diploe, and tables of the skull bones, through the 

 Pacchionian bodies of the arachnoid, moreover, some com- 

 pensatory escape must take place from the other "points 

 of exit," such as the olfactory apparatus and apertures, and 

 the coccygeal gland and related structures. The cerebro- 

 spinal lymph, which, in its normal physiological condition 

 of fluidity, enters and penetrates all the passages and spaces 

 above mentioned with ease, and without difficulty, on be- 

 coming contaminated, and loaded, or thickened, with the 

 undealt with residuum of the pituitary material, or neuro- 

 glial and nerve mud, resulting from the incapacity of the 

 pituitary gland structures, and associated anatomical parts, 

 to perform their normal physiological functions, breaks up 

 en route, leaving its more solid impedimenta, in the form 

 of more or less amorphous deposits, amid the interstices 

 of certain of the structures, which, from affinity for its 

 elements, or histological difficulties in the way of their 



