Licence: Public Domain Mark
Credit: Acromegaly / Translated by F.R.B.Atkinson. Source: Wellcome Collection.
Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)
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![enlarged extremities of tlie body, in most cases also in tlie neck and trunk. The epidermis is increased in thickness, frequently also the height and breadth of the papillce is increased (Duches- nau, Marie-Marinesco). The cells of Meissner's touch corpuscles may also be increased. The cells of the rete Malpighii contain abundant pigment. The cutis is much thickened, often to double or treble the normal. Its bands of cellular tissue sclerosed. The sheaths of the nerves, vessels, and glands are thickened, their nuclei also may be increased. The STveat glands are hypertrophied, the sebaceous glands are often prominent (Arnold). The fat globules of the subcutaneous cellular tissue are enlarged, and closely enveloped by dense bands of cellular tissue. The small vessels at once attract notice owing to the thickness of their wall and dilatation. The thickening of the outer sheath of the cutaneous nerves extends up to the endoneu- rium, the nuclei of the sheaths of Schwann are increased, the fibres partlj- wanting in substance (Marie-Marinesco). The other changes in the skin, such as those of the hair and nails, we describe, to avoid repetition, i]i the symptomatology (Chapter iv.). The muscular system is, as a rule, lax and atrophied (Duchesnau, Holsti, Arnold, Claus and Van der vStricht, Comini, and others). Microscopically all possible forms of degeneration and atrophy of fibres are present, even in such muscles which, on dissection, show apparently a normal appearance. There is usually, in addition, an increase and sclerosis of the interstitial cellular tissue. Yet simple atroph}- of the muscles without degeneration also occurs (Mosse and Daunic). In individual internal organs, an uniform increase, an hypertrophy of the v. hole organ, splanchnomegaly, is pre- sent in many cases. It is a condition which, except the true enlargement of the breast and congenital increases, e.g., of the brain, is one of the greatest rarity, and stands quite alone in pathological anatomy. As it often occurs in acromegaly, it certainly belongs to the phenomena of this disease. It is present in the central nervous system, eyeball, gastro-intestinal canal, liver, and](https://iiif.wellcomecollection.org/image/b21273388_0040.jp2/full/800%2C/0/default.jpg)
