ACROMEGALIA 



By C. BENDA, Berlin 



The erroneous idea that the gigantic is to be looked upon as an expression 

 of prehistoric times — primordial — is firmly rooted in the human mind. 

 When we think of the seas and forests primeval as inhabited by monsters 

 like the plesiosaurus and the megatherium we readily conckide that a primor- 

 dial race of gigantic people must have represented the survivors of the animal 

 kingdom who vanquished these leviathans. We are content with the role of 

 dwarfed epigones, and in the specimens of unusual size occasionally seen we 

 acclaim the revival of this primordial power. Science has proven these fan- 

 tasies to be incorrect. We can prove, or at least infer, that prior to these 

 giant beasts, as well as to-day, there existed prolific races of smaller beings. 

 Prominent scientists assume that the original forms of the vertebrate animals 

 were dwarfed forms. Nothing conflicts with this hypothesis, and much 

 favors the probability that the apelike proanthropos also, and some at least 

 of the earliest races of man, were dwarfs, even though other primordial races 

 may have early attained a larger structural development. Thus our views 

 regarding giants have been fundamentally changed, since it is unlikely that 

 giants are to be considered as atavistic or primordial types. In the year 1872, 

 Carl V. Langer first proved by careful studies that besides a normal form of 

 giant skulls a pathologic one may be distinguished. To-day the opinion is 

 expressed that giant growth is commonly the result of a pathologic process. 



This change of conception is intimately associated with our increasing 

 knowledge of that process of pathologic growth which is the subject of 

 this article — acromegalia. The investigations of Pierre Marie in the year 

 1886 are to be regarded as the foundation for this knowledge. Although cases 

 of the disease had been observed prior to this time and to some extent well 

 described, for instance, by the Italian Verga, it was, as Sternberg says, the 

 labors of the French investigator that introduced the disease into the clinic 

 from medical monstrosity and curio cabinets. Marie characterized the affec- 

 tion by means of the peculiar symptoms which had also been noted by other 

 observers, and of which now one, now another, proved most interestmg. He 

 also worked out the principal clues for the differentiation of this process from 

 other affections which had some symptoms in common with it. Mane deserves 

 still further credit for giving to the disease its characteristic, euphonious, and 

 easily remembered name, for we must remember how readily the human mmd 

 adheres to a scheme, and by adopting a distinctive name grasps the 

 conception which the name embodies. Nevertheless there is an impor- 

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