This condition is in all probability to be included amongst the diseases due to alteration of secretion and excretion. The gland concerned is the Pituitary body, which in all recent post-mmiem examinations has been found greatly hypertrophied and sometimes cystic. The enlargement is sometimes so great as to cause enlargement and deformity of the sella turcica.

The term Acromegaly means enlargement of the extremities, and it is used to designate a condition whose recognition is chiefly due to Marie and Souza Leite. The course of the disease is about fifteen years, and it is characterized by a progressive enlargement of the face, chiefly the nose and lower jaw, marked enlargement of the hands and feet, enlargement of the tongue, muscular weakness, and severe headache.

Fig. 121. - Acromegaly in a man aged forty-nine. (Middleton).

The anatomical lesions are principally of the bones. There is an enlargement of their outline by a new-formation of cancellous bone. Thus the bones of the hand are increased in breadth, and are rough on the surface, but there is no proportionate increase in length. In a case described by Middleton, the elbow, wrist, and knee-joints were affected, but this is exceptional. The integuments are enlarged over the hypertrophied bones, and very great deformity ultimately results, the hands being like great unwieldy fins. (See Fig. 121).

Literature

Marie and Souza Leite, New Syd. Soc. trans., 1891; Recklinghausen, Virch. Arch., cxix.; Duchesneau, L'acromegalie, 1892; Middleton, Clin. Records, 1894.