A case of acromegaly / by W.B. Hadden and C.A. Ballance.

  • Hadden, W. B. (Walter Baugh), 1856-1893.
Date:
[1888]
Catalogue details

Licence: Public Domain Mark

Credit: A case of acromegaly / by W.B. Hadden and C.A. Ballance. 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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    ence, and across the centre of the sole 11£ inches. There is much subcutaneous fatty tissue along the outer border of the foot on the plantar surface, and below the internal malleolus, but very little over the dorsum. The thickened parts form pads, which can be readily taken up by the finger and thumb. As in the case of the hands, there is no deformity of the feet; they are simply gigantic, and nothing more. In marked con- trast with the enlarged hands and feet, the forearms and legs exhibit no increase in size. The skin everywhere is soft, supple, moist, and in every respect natural. The hair on the scalp is soft and glossy, and has no tendency to become brittle or to fall out. The speech is not slow, but it is distinctly guttural. She articulates every word perfectly. It may be mentioned here that the patient first came under the notice of Mr. Ballance for enlargement of the tonsils, which was of such unusual extent that there was interference with speech, deglutition, and respiration. Though the tonsils were removed the speech still remains affected. The tongue is large, probably hypertrophied. The soft palate is normal. The heart and lungs are natural. There is no reason to believe that the thymus gland is enlarged, the percussion note over the upper part of the sternum being natural. The abdomen was not examined. No albumen has been found in the urine. So far as we can ascertain there exists nothing abnormal in the size or distribution of the large arteries of the upper extremities. Briefly, the enlargement of the hands is not accompanied by any appreciable change in the vascular supply. The patient was unwilling to allow anything but a cursory examination of the lower extremities; but so far as we could make out there was no abnormality in the size of vessels, and there were no varicose veins. (Plate VI.) We have recently discovered that the patient is almost completely blind with the right eye. The date of failure is uncertain, but she believes the sight has been dim since she had what she called diphtheria three years ago. Four months since she discovered that the sight was nearly gone. There is no history of right-sided headache. Mr. Nettle- ship kindly made an ophthalmoscopic examination, and re- ported as follows :— There is very little direct action to light of the right pupil, but the indirect action is good. There is blue-white atrophy of the right optic disc; the veins are very tortuous, and there is a little tissue at centre of the disc.