Acromegaly / by Maximilian Sternberg ; translated by F.R.B. Atkinson.

  • Sternberg, Maximilian, 1863-
Date:
[1899]
Catalogue details

Licence: Public Domain Mark

Credit: Acromegaly / by Maximilian Sternberg ; translated by F.R.B. Atkinson. Source: Wellcome Collection.

    34/186 (page 30)
    ACROMEGALY, tliis is quite a normal result, ■\vliicli anyone can confirm in very many skeletons of liands Jf normal indi\ iduals. ,A. Aisit to tlie Lone room of any large dissect- ing room will confirm it. The Rontgen pLotograplis of sound Lands also clearly sliow it. In tLe numerous magnifi- cent pLotograpLs wliicL the Prussian :Minister of *IVar cxhiLited of different injuries to fingers, foreign Lodies in the hand and the like, on the occasion of the loth Congress for “ innere Medicin ” in Berlin, the most Leautiful, ahun- dantly studded prickly points on the terminal phalanges could he oLserved in very many hands. This form of the terminal phalanges has nothing to do with acromegalv. If the changes in the skeleton are surveyed as a whole, it is seen that a number of these changes stand clearly related in genetic connection, as certain changes in the one Lone necessarily evoke and give rise to changes in the other Lone. If a certain abnormal increase in size takes place in any one Lone, the mechanical relationships of the whole system which bears and supports that Lone are altered. The alterations in the mechanical relationships (changes of size, weight, pressure, and direction) produce an alteration in the growth of the other bones. This change of growth leads again to new mechanical relationships, and so gradually the one Lone adajits itself to another until a certain condition of equilibrium is arrived at. If, however, the increase of the one Lone, which we have hypothetically regarded as primarily diseased, goes on increasing always in the same way, it is clear that the secondary changes in the remaining bones will also con- tinue in a perfectly fixed manner. Some such genetic relationship Langer and Klebs have already discussed. AYe place together as follows the con- ditions acknowledged at the present time, but especially emphasise that no hypothesis should be advanced as to which disease is the primary one. I he strong formation of the masticatory apparatus de- mands powerful points of compensation in the head. These come about either by thickening of the solid, or through <lilatation of the hollow siipports, or through distri- bution of the weiglit over a larger surface. To the first the liypertro]ihied zygomatic arch corresponds, to the