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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    megaly which is not acromegaly; and many cases of acrome- galy have been diagnosed for a longer or shorter time even nntil post mortem examination as other diseases. Two possibilities are to he borne in mind in the differential diagnosis: — 1. Single symptoms, particularly on the side of the internal organs, may force their way so much to the front that they appear as independent diseases, and the disease as a whole is overlooked. 2. The changes in the external shape of the body may give rise to mistakes. Of the independent diseases, which, by reason of partial appearances of acromegaly, may he confounded with it, w& must consider: tumour of the brain, Basedow’s disease, dia- betes, progressive muscular atrophy, disease of the reproduc- tive organs, acroparasthesia, rheumatism, traumatic neuroses, and feigned diseases. Cranial tumour, owing to headache, apoplectiform attacks, disturbances of the eyes, often early directs the patient’s attention to himself. If the disease can now be localised by means of homonymous hemianopsia, with hemiopic pupil- lary reaction in the middle fossa of the skull, or even through bitemporal hemianopsia in the region of the chiasma, then the possibility of acromegaly should not be forgotten. Exophthalmos, amenorrhoea, glycosuria, polyuria* (which, according to the older descriptions, were said to be symptoms of hypophyseal tumour—cf. p. 68) immediately suggest this possibility. The idea is supplied with proof in the changes of the shape of the body. But it is to be remem- bered that a tumour of the hypophysis may exist with- out acromegaly, and that it may be combined with one of the conditions similar to acromegaly to be described here- after (as cranium progeneum or syringomyelia), and there- fore the minute details must be carefully considered. Acromegaly, especially at the commencement, has been re- peatedly mistaken for Basedow’s disease (Lancereaux, Wolf). Exophthalmos, goitre, palpitation of the heart, abnormal * All these symptoms are present in the case of H. P. Potter and G. M. Atkinson iBrit. Med. Jour., 1884, I., p. 57), which is on that account highly suggestive of acromegaly.