Journal : International Clinics. vol. iii., 6th series.
Philadelphia : Lippincott company, 1896.
Description : pp 109-110, [1] pl.; ill.: 1 photo.
Photograph : 1 half-tone.
Subject : Acromegaly — Clinical photography.
GENTLEMEN, — The circumstances connected with this case are interesting in some respects. A man, aged thirty-five, was admitted to my ward in the Glasgow Western Infirmary on January 23, 1885. He had what was regarded as a chronic rheumatic affection of various joints, with a sense of crackling on moving them. He was treated pretty successfully, as regards the joints, and was able to walk or even run a little before he left.
My attention was arrested by his peculiar appearance. He was five feet seven inches in height. His head was remarkably long from before backward, the hands were large, and the fingers broad and flat. The legs were thick and flabby, and the feet very broad and flat, Again and again I commented on his appearance, and one of my former pupils, seeing the interest taken in his case from this point of view, kindly photographed the patient in two different postures, one, the larger of the two, to show the upper part of the body, the other to show the feet as well. The former is here reproduced (see Fig. 1), the hands having been arranged so as to be well seen. The patient had lost an eye long before.
There was a supposition, on the part of the patient, that his hands had become larger than they had formerly been, but no accurate account of the changes in his appearance was obtained.
Some of the students, or resident assistants, seeing the interest I took in the man's appearance, informed me that in the ward of my colleague, Dr. Gairdner, in the same infirmary, there was a man who looked like the brother of my patient, but was really quite unconnected with him. I went to the ward indicated, saw this patient, and was also struck by the great resemblance to my case.
In 1894, in the Glasgow Medical Journal, Dr. George S. Middleton published, with photographs, " A Marked Case of Acromegaly with Joint Affections." (This has since been published in his " Clinical Records from the Glasgow Royal Infirmary," Glasgow, 1894.) On reading his case, I found that the patient he described had been formerly in Dr. Gairdner's ward, and from the photograph I recollected his general appearance. On looking up the dates, I found they agreed. As Dr. Middleton explains, Dr. Gairdner, like myself, had been struck by the physiognomy of his patient, and had made a long note, in January, 1885, on the subject. Of course, this note of his and this photograph of mine were before Marie's Thesis appeared in 1885. But I could make nothing of my case except to preserve a photograph.
On having my attention recalled to the case, I made inquiry as to whether the patient could be traced ; but I found that he had died, and so nothing further could be learned.
