Acromegaly, with the description of a skeleton / by Henry Alexis Thomson.

  • Thomson, Alexis, 1863-1924.
Date:
[1890]
Catalogue details

Licence: Public Domain Mark

Credit: Acromegaly, with the description of a skeleton / by Henry Alexis Thomson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    deformans, osteo-arthritis, and rickets, and constitute only one element in the general trophic disturbance which accompanies these diseases. Sternum, Ribs, and Costal Cartilages.—The sternum and ribs are of gigantic size; the longest of the latter, i.e., the 7th, measuring 380 mm. along the convexity from end to end. The manubrium sterni appears of great transverse breadth on account of the complete incorporation with it of the ossified cartilages of the first rib on either side. The ensiform and remaining costal cartilages show various degrees of ossification, the process commencing on the outside, so that each cartilage becomes enveloped by a crust of new bone which has a porous structure and reticular arrangement, reminding one of the calcareous deposit seen on objects exposed to the contact of water containing an excess of lime salts. At either end of the cartilage the new bone is fused with the compact shell of its rib and with the sternum respectively. Such an extensive ossifi- cation of the cartilages is very unusual at the age of thirty-six ; when taken in conjunction with the changes already described in the vertebrae, and with similar bony developments to be noted in the bones of the limbs, one may conclude that there exists in acromegaly a tendency to ossification of ligaments, cartilages, and connective tissues generally, exactly correspond- ing to what is seen in cases of osteo-arthritis, viz., the develop- ment of large masses of bone in the substance of muscles and tendons in parts of the body distant from those affected by the arthritis itself. The Bones of the Extremities present certain characters in common which may be referred to before I describe them indi- vidually. They are devoid of those elegant outlines which an anatomist is accustomed to look for in a well-formed skeleton; in appearance they are heavy and clumsy, this being probably due in large measure to the alteration in structure of their superficial layer. The latter, instead of being smooth and almost glistening, as it is in a properly macerated bone, presents a roughened spongy appearance with an infinite number of shallow longitudinal grooves, occupied in the recent state by blood-vessels entering the bone, evincing therefore an unusual degree of vascularity in the periosteum. The latter condition