1. Acromegaly and the Giantism of Nutritive Over-loading are one, and are dependent for their different
lines of evolution upon differences in the constitution
of the body which, in turn, is dependent upon the age
of the whdle body or of parts of the body or of inborn
differences of the body cells.
2. Nutritive overloading is either systemic and
dependent upon failure of the exogenous metabolism or
local to the tissues and dependent upon failure of the
3. Failure of the exogenous metabolism may be
A. Of an undue and altogether excessive
strain being thrown upon its mechanism as the result
of an abnormally great intestinal absorptive power. •
B. Of changes in the liver which may be
secondary to typhoid fever or some other acute infectious
C. Of changes in the ductless glands which
govern the metabolism of the liver. In some cases
these are of unknown origin, in others, they appear to
be secondary to some acute disease, still in others to
some profound nervous disturbance whatever the intimate
meaning of that may be.
4. Enlargement of the pituitary occurs in all
those cases in which there is systemic nutritive overloading
and is to be regarded as a functional, compensatory
hypertrophy, frequently carried to excess and
frequently associated with secondary degenerative
5. Enlargement of the pituitary does not occur
in cases in which there is no systemic nutritive overloading.
6. Acromegaly and the Giantism of nutritive
overloading are best classed together under the title
7. Acromegalic-Gigantism is a symptom of excessive
nutritive supply to the somatic cells.
8. The growth changes of Acromegalic-Gigantism
affect most markedly the most absorptive cell areas
of the body which are found,first, in the epiphyseal
cartilages, second, comparing each tissue with tissues
of its own kind in the ontogenetically and phylogenetically more youthful areas of the body.
9. Acromegalic-Gigantism is inevitably associated
with the development of a precocious senility which,
unlike true senility, is of environmental, and not of
protoplasmic, origin. There is, therefore, always
a chance of rejuvenescence in the presence of in-
creased blood supply. This almost invariably occurs
and bossing and buttressing of the bones results.
10. Acromegalic- Gigantism superficially resembles
Eunuchoid Gigantism and Physiological Giantism, but is
essentially different from both in origin and result.
In origin because in them there is no loss of metabolic
control; in result because they do not carry with them
the inevitable doom of a precocious senility and an