The feet are similarly enlarged,
although the big toe may be relatively much larger. The nails
also become broad and large. The face increases in volume and
becomes elongated, in consequence of the hypertrophy of the
superior and inferior maxillary bones. The latter often projects
beyond the upper teeth. The teeth become separated, and the soft
parts increase in size. The nose is large and broad, and the skin
of the eyelids and ears is enormously hypertrophied. The tongue
is greatly hypertrophied. The disease is of long duration, and
late in the history the bones of the spine and thorax may acquire
great deformity. As we know little of the influences and sources
governing nutrition, the pathology and etiology of acromegaly are
obscure. Marie regards the disease as a systemic dystrophy
analogous to myxedema, due to a morbid condition of the pituitary
body, just as myxedema is due to disease of the thyroid. In
several of the cases reported the squint and optic atrophy and
the amblyopia have pointed to the pituitary body as the seat of a
new growth of hypertrophy. Pershing shows a case of this nature.
The enlargement of the face and extremities was characteristic,
and the cerebral and ocular symptoms pointed to the pituitary
body as the seat of the lesion.
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