92 THE PITUITARY AND 



gigantism, including Patrick O'Byrne, Hunter's 

 famous giant, and Patrick Cotter, the Bristol giant, 

 have enormous sellae turcicae to accommodate the 

 enlarged pituitary gland. It is probable that giants 

 usually suffer from acromegaly as well. There are two 

 authentic casts preserved in Bristol of Patrick Cotter's 

 hand, one of which is much larger than the other ; 

 indeed, it is colossal, measuring 12 inches from wrist 

 to finger-tips, whereas the earlier cast measures only 

 II inches. His shoes, which are also preserved, are 

 15 inches long. It is therefore clear that although 

 he was 7 ft. 10 in. high, his hands and feet were large 

 out of all proportion, and that the hand rapidly 

 increased in size between the taking of the first 

 and second casts. The lower jaw was enormous, 

 and out of all relation to the rest of the skull.* 

 Cushing gives some striking photographs of a living 

 giant, 8 ft. 3 in. high, showing enormous hands 

 and feet. 



Associated with the enlarged bones of the face, 

 hands, and feet seen in acromegaly, there are in some 

 cases other features ; these are glycosuria, amenor- 

 rhoea, impotence, and, in the young, failure of the 

 secondary sexual characters. The temperature is 

 subnormal. This train of symptoms will recall the 

 effects of total or partial removal of the gland in 

 animals. 



Not only the bones, but also the viscera, may be 

 increased in size in acromegaly : the kidneys, liver. 



* E. Fawcett, Jour. Royal Anthropological Institute, 1909, vol. 

 xxxix. p. 196. 



