. Acromegaly . acromegaly offers also some historical has shown it to be very probable (7) that the Franco-Italian type of clown, the hunchbacked Punchinello, isone of acromegaly, so also Souques (2) for the English Punch. Lastly, the relationship of acromegaly to gigan-tism throws new light on old tales and saws. 14 ACROMEGALY. II. EEYIEW (»F THE CLIXIC.^L FEATUEESOF THE DISEASE. Acromegaly persists for many years, in most cases as longas ten. The commencement is traceable to most variedcauses; nsnally it is imperceptible. Very often tlie diseasecommences with pain and parasthe
. Acromegaly . acromegaly offers also some historical has shown it to be very probable (7) that the Franco-Italian type of clown, the hunchbacked Punchinello, isone of acromegaly, so also Souques (2) for the English Punch. Lastly, the relationship of acromegaly to gigan-tism throws new light on old tales and saws. 14 ACROMEGALY. II. EEYIEW (»F THE CLIXIC.^L FEATUEESOF THE DISEASE. Acromegaly persists for many years, in most cases as longas ten. The commencement is traceable to most variedcauses; nsnally it is imperceptible. Very often tlie diseasecommences with pain and parasthesia, affecting the arm andleg, often also the trunk or face, and may for a long time bemisinterpreted. In females, cessation of menstruation isusually one of the earliest symj^toms. By degrees a change in the appearance of the face strikesthe patients friends, and finally also the patient nearest relations, even his mother, do not recognise himif they last saw him in good health. Figs. I and 2 showcu31924012161463. 17
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