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.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    this is quite a normal result, which anyone can confirm in very many skeletons of kands of normal individuals. A visit to tlie bone room of any large dissect- ing room will confirm it. The Röntgen photographs of sound hands also clearly show it. In the numerous magnifi- cent photographs which the Prussian Minister of War exhibited of different injuries to fingers, foreign bodies in the hand and the like, on the occasion of the 15th Congress for “ innere Medicin ” in Berlin, the most beautiful, abun- dantly studded prickly points on the terminal phalanges could be observed in very many hands. This form of the terminal phalanges has nothing to do with acromegaly. 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 bone necessarily evoke and give rise to changes in the other bone. If a certain abnormal increase in size takes place in any one bone, the mechanical relationships of the whole system which bears and supports that bone 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 bone adapts itself to another until a certain condition of equilibrium is arrived at. If, however, the increase of the one bone, which we have hypothetically regarded as primarily diseased, goes on increasing always in the same way, it is clear that Ihe 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. We 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. The 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 dilatation of the hollow supports, or through distri- bution of the weight over a larger surface. To the first the hypertrophied zygomatic arch corresponds, to the