Dicky is said to be ‘one of the most deformed pieces of mortality I ever saw, and of most uncouth manner of speech.’ Rowntree A The History of Scarborough

In looking at early cases of acromegaly it is necessary to remember the role played by artistic license. Is the subject really an acromegalic? Is the portrait an accurate representation or the artists personal portrayal or even a caricature? 

Acromegaly and early man

The links between acromegaly and early man range from possible to highly improbable, from atavistic theories to being duped by a scientific fraud.

Early atavistic theories of causation

Piltdown man

Neolithic acromegalic

Early atavistic theories of causation

Early after the differential diagnosis of acromegaly came publication of Darwin’s Origin of Species (Check date)

Huxley on Neanderthal re: acro

fig 177 in Keith pg 487, 1937.

Campbell (1896) 962 and Keith A (1911) 961 both suggest a direct resemblance between acromegalic facies and neanderthal or man’s ape-like progenitors. The atavistic view saw acromegaly as a reappearance of ancestral traits or a reversion to those characteristics. The double possibility of throwing some light on the structure of man’s immediate ancestors and finding a cause for acromegalic occurrence in man are adequate stimulation for these and similar papers.

Piltdown man

This scientific oddity only qualifies as an illustration through Adami saying that “Sir Auckland Geddes , has impressed upon me that the earliest known human fossil is pathological, pointing out that the remarkable thickness of the Piltdown skull, coupled with the characteristic outline of the temporal ridge can only find their explanation by a diagnosis of acromegaly, and suggesting that it is thanks to this disease and its results that we owe the survival of these remains through the ages.”

Not to suggest that acromegaly is a zymotic disease (a disease regarded as caused by the multiplication of germs introduced from outside)

This contention obviously looks ridiculous in hindsight but with the difficulties experienced in reconciling the pieces of the puzzle using the pathology of acromegaly is a useful if erroneous escape. (Adami’s book is oddly rather Lamarckian in emphasis.)

Atkinson FRB. 1936

". . . Sir Auckland Geddes considers the Piltdown skull shows by its configuration it belonged to an acromegalic and dates therefore from 100,000 years, there is not sufficient evidence to be dogmatic on the point.” (cf Adami JG 1918)

Neolithic acromegalic

Brothwell 1982

A case of acromegaly in a neolithic individual from switzerland has been described by Schlaginhaufen (1925), but the diagnosis has since been disputed.

(Sigerist 1951)

A case of neolithic acromegaly from switzerland has been described by O. Schlaginhaufen but his diagnosis has been contested and must remain uncertain since it is based on the examination of an incomplete femur only.

Possible neolithic case of acromegaly (Schlaginhaufen, O 1925).

Early history

King Saul (Historical dates needed)

Levin (1965) has suggested that King Saul's raging headaches and missing David with his javelin could be due to the gradual increase in size of a pituitary tumour.

Need quotes from bible (1 Samuel 4:2, 9:2, 18:11, 19:10)

Roman period - Marcus Antonius

Cheselden W 1723 Cheselden W 1712

Bones found in an urn marked "Marcus Antonius in the place of the Roman camp near St Albans." Cheselden used his camera obscura for his drawings of the bones in his publication Osteographia.

Mediaeval period

12th century - Homo Gardarensis

Perkins M (1931) - also use re: Giants chapter and re: possible hereditary overactive pituitary gland.

"It is certain that descendants of Ulf the fearless settled in Greenland, because soon after its discovery, fourteen ships reached that land from Borgafjord of Skallagrim's settling, through whom he derived from Ulf: it is quite possible that the Gardarik skulls include some of Ulf's descendants."

The Gardar skull may be an extreme example of this "berserker" stock but similar less pronounced specimens have been recovered in the same cemetery (Pederson PO 1944).

Keith A (1931) 12th century skull, Gardar Greenland evidence from vault and mandibular fragments. Brøste K et al ( )

Perkins M (1931) Acromegaly in the far north. Nature no. 3229; 128: 491.

Brøste K Fisher-Møller Pederson PO The mediaeval norsemen at Gardar. Meddon Grønland 89 No 3.

Keith A. (1931) New discoveries relating to the antiquity of man. London p. 483-99. Chapter 32 - The problems raised by the discovery of Homo Gardarensis.

Perkins M. (1931) Acromegaly in the far north. Nature 128 (No 3229) p. 491-2.

Late mediaeval - Kloster monastery

Isager K. (1936) Skeleton excavated from graveyard late mediaeval monastery, Kloster , Copenhagen.

Isager K. (1936) Skeletefundene ved øm Kloster. Copenhagen.

13th Century - Figure on Reims cathedral

This carved figure bears the hallmarks of acromegaly, with hand held to weary head possibly a sign, as fellow sufferer Dr Mark suggests, of the severe headache afflicting the woman (Mark LP. 1912, 1914). Unfortunately Atkinson reports (1930) being unable to relocate this statue due to then damage inflicted by the 1st World War.

" . . . . of special interest at the present moment, is a carved figure of a woman, dating from the thirteenth century, which was placed high up on one of the flying buttresses of Reims Cathedral. This statue has been described as pointing out in a striking way the physical characteristics of acromegaly. As it stood on the north side of the cathedral, which was the one which suffered least from the early bombardment of Reims leaves one little hop that this interesting relic of the past, after weathering the storms of seven centuries, is not now to be reckoned amongst the innocent victims who have fallen before the spread of German Kultur." Mark LP 1914

Figure seen on Reims Cathedral by Leonard Mark (1912).

Mark LP. (1912) Acromegaly: A personal experience. London: Baillere, Tindall & Cox.
Mark LP. (1914) A case of acromegaly 200 years ago. Lancet ii, 1412-3.
Atkinson FRB. (1930) Acromegaly. London:

Ming Tschu Yuan Chang b.1368

The founder of the Ming dynasty (1368 - 1644), Tschu Yuan Tschang, is shown in his portraits to have characteristics of acromegaly in the face, especially the elongation of the jaw which hints at malocclusion of the teeth. Under his rule China prospered, so that the case is an exception from the commonly accepted rule that sufferers of acromegaly are not capable of much physical or mental exertion when the disease is fully developed (Seiffert G 1937).

Ming Tschu Yuan Chang, note especially the elongation of the mandible (Seiffert G 1937).

 15th and 16th Century

Das Brevarium Grimani

Flemish faces, acromegalic or acromegaloid? Das Brevarium Grimani (1903-08, Plate no 1571).

Wm Pearce Coues noticed the acromegalic type facies in this breviary, following Dr Leonard Mark's article on Richard Dickinson (Mark LP 1914) and the figure on Reims Cathedral (Mark LP 1912), and described the appearance of one of its plates as follows;

" . . . an exhibition of miniatures at the Boston Public Library from the Grimani Breviary is of interest. This breviary contained nearly 2,000 pages and was the masterpiece of the Flemish miniature paintings. It dates from the 15th century. Some of the paintings are thought to be by Hans Memling. No 1571 is the picture that interests us in this connection. It is of St Catherine disputing with the doctors (3rd century). Without doubt, contemporary Flemish faces (15th century) were the models. This picture is by an unknown artist. In the group around St Catherine are two figures which stand out unquestionably as typical acromegalics the immense prognathous jaw, and large face in one figure being particularly interesting. One of the lower figures had also typical facial characteristics. In other fifteen pictures, some of the sacred subjects, some of profane, there is no hint of an acromegalic face, though the broad features of the Flemish type are faithfully portrayed." (Coues WP 1915)

Whether these faces are strictly acromegalic is debatable, especially in view of the cosmopolitan trade in Belgium with a wide variety of ethnic facial characteristics. The close-up below shows the faces clearly but I leave the decision as to whether any are 'acromegalic' to the viewers imagination and safely term the facies as acromegaloid.

Flemish faces, acromegalic or acromegaloid?

1425 - 1474 Henry IV of Castille "The impotent"

Notes Marañon G - Need to access images, engraving, seal.

Marañon G Essayo biologico sobre Enrique IV de castilla y su tiempo, Buenos Aires, 3rd ed. Coleción Austral.

Gregorio Maranon http://www.fund-gregorio-maranon.com/001/pag1i.htm

17th and 18th Century

1670 - 1738 Richard Dickinson

Dr Leonard Mark (1914) reported on 'A case of acromegaly 200 years ago" stimulated by interest in his biography "Acromegaly a personal experience" (Mark LP 1912) from Scarborough antiquarian Dr Everley Taylor. Dr Taylor recognised the characteristics of acromegaly in Richard Dickinson who ran a spa in Scarborough in the 18th century.

An account of Richard Dickinson is included in the manuscript diary of Richard Du Cane, junior, 1726-29 (Addison W 1951).

'Wednesday, 26th October 1726: This morning went to the Spaw, which was built by Richard Dickinson and now kept by him. He is a very deformed man. From thence to the Castle, which is very large and high. Also we were in the Church, which is very large; but when the Castle was battered, some of that was beat down in Oliver's time.' (Addison W 1951)

Addison (1951) also records the description of Dicky, from Arthur Rowntree, as being 'one of the most deformed Pieces of Mortality I ever saw, and of the most uncouth manner of speech.' However this must have worked to Dicky's benefit as he is also recorded as having built two houses for visitors, ran a Spa and from Mark's comments he was very popular with painters and artists from plates to engravings 'He did not escape the notice of painters and poets of his time, and there are not less than seven original resemblances of him preserved by different artists, and copies of the same innumerably multiplied' so perhaps his deformity was useful in enhancing his income and notoriety.

Knaggs RL(1935) also includes an image of Richard Dickinson in his paper on acromegaly.

Portraits in the National Portrait Gallery Archive Collection

Richard Dickinson (1669-1739), 'Governor of Scarborough Spaw' Sitter in 2 portraits NPG D1759 Richard Dickinson after Hans Hysing mezzotint http://www.cogapp2.com/NPGHome/live/search/person.asp?LinkID=mp55668
NPG D1760 Richard Dickinson

Scarborough

History of Scarborough http://www.history.scarborough.co.uk/

North Yorkshire County Library, Vernon Road,  Scarborough, Y011 2NN 01723 364285. Scarborough Borough Council: Scarborough Borough Council (e-SBC) SBC Economic Development Office http://www.e-sbc.co.uk/

19th Century

1856 Dr Hugh Diamond "The face of madness"

Dr Hugh Diamond's photographs of patients, Female department of Surrey County Lunatic Asylum (Gilman SL 1977).

References Gilman SL 1977, Taurek R 1980, Diamond HW 1856, Connolly J 1858.