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.

    36/186 (page 32)
    D o2 ACROMEGALY. skeleton sliow an entirely ditferent condition. One tiling is clear in any case, that considerable changes in form of single hones are not to be explained by any simple methodical process, but only through co-operation of absorption, apposi- tion, and interstitial increase. There is invariably thickening of the periosteum, as also of the attachments of the tendons and aponeuroses. The periosteal bands of cellular tissue are increased, the arteries thickened and dilated. In many places there apjiear, as a lesult, layeis of neiv formations on the bones. This occurs firstly, as has already been entered into and explained in the macroscopic description, especially in the position of the muscular and ligamentous attachments. This method of increased growth produces, in co-operation with the increase in size of the vessels, the rough, porous appearance of the bones. Secondly, the periosteal formation of new bone may also be i ery diffuse and appear as a sclerotic hvpertrophy, as IS found on the roof of the skull (Thomson), the diaphvsis of the long bones (Femur, Brigidi), or the phalanges (Boltz). A second series of changes arises from the marrow of the bones. They take place especially in those’ bones in which during growth the marrow remains jireserved (Duchesnau*): skull, vertebrte, clavicle, metacarpi and metatarsi. The pro- gress of absorption of old bone goes hand in hand with a slow new formation. The old and young bone are crowded together (Klebs, Duchesnau, ]\Iarie-Marinesco). Sometimes the process of absorption predominates. Thus in a case of Hutchinson s, the whole skeleton showed considerable osteo- porosis, in a case of Broca’s single parts of the pelvis, and especially the tarsi (the os calcis pitted under the finger). In general, in the bones in acromegaly, the medullary spaces between the osseous septa are enlarged, but these latter may themscB es be hypertrophied. The whole medullarv canal may be irregularly widened (Brigidi). ^ Since the myelogical and periosteal processes may be asso- ciated in various ways, manifold appearances may arise. At one time the compact tissue is much thickened at the * The thesis of Duchesnau is fashione'l uiirler the pniilauce of Konaut, who has admittedly acquired verj’ great merit concerning the histology of the bones.