American practice of surgery : a complete system of the science and art of surgery . proportionately small; there are evidences of infantilism, knock-knee, andgenital inadecj[uacy; and, finally, physical and mental weakness. Besides this form of general gigantism, or, as it might perhaps be more cor-rectly styled, macrogenesij, there are certain less extreme manifestations of thetendency in the form of local hypertrophies, which are undoubtedly of develop-mental origin. Such are the forms which involve the head or extremities. Inleontiasis ossea there is an excessive and remarkable deformity o
American practice of surgery : a complete system of the science and art of surgery . proportionately small; there are evidences of infantilism, knock-knee, andgenital inadecj[uacy; and, finally, physical and mental weakness. Besides this form of general gigantism, or, as it might perhaps be more cor-rectly styled, macrogenesij, there are certain less extreme manifestations of thetendency in the form of local hypertrophies, which are undoubtedly of develop-mental origin. Such are the forms which involve the head or extremities. Inleontiasis ossea there is an excessive and remarkable deformity of the bones ofthe face and skull, which appears to be essentially a diffuse hyperostosis. Localgigantism in children is especially common in the upper limbs, and may be uni-lateral or bilateral. Hemihypertrophy of the body has also been or more digits may be affected (macrodactylia), or a whole limb. Apart fromthese instances of local gigantism, which are characterized mainly by an increasein the bulk of the part, there are certain other forms of numerical increase,. Fig. 54.—Cross Section of the Heart, to Show Hypertrophy of the TValls. The cause: increasedperipheral tension. (Pathological Museum, McGill Universitij.) which some authorities would include under the heading gigantism. Suchare polydactylism, accessory ribs, and supernumerary organs. These peculiaritiesare occasionally associated with general gigantism. Extrinsic Hypertrophy.—Hypertrophies which are not dependent on someconstitutional and inherent peculiarity, but are the result of some externalcause, are called extrinsic hypertrophies. They are, in other words, is undoubtedly somewhat difficult, if not impossible, in many cases to drawthe line between the congenital and the acquired forms; for some cases, whichclosely resemble the congenital varieties, may on occasion result from externalcauses. Such are certain forms of ichthyosis and elephantiasis. It is not impos-sible that these
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