The Giant in Literature and in Medical Practice

jjk. The Giant in Literature and in Medical Practice* Helmut Bonheim The giant has long been a popular figure in literature, not just in children's stories and fairy tales. But more than merely a mythical or literary phenomenon, the giant is also a continuing clinical problem: people throughout the ages have suffered from acromegaly, an inordinate bodily growth. The symptoms of acromegaly include changes in the growth and quality of hair, the hunching of the back, the swelling of lips and ears, pain in the joints, impaired vision, and bouts of inordinate thirst. Both the frequency and the obviousness of the symptoms are such that the disorder must have been observable in ancient times as today,1 so it is understandable that descriptions of giants in literary works reflect some familiarity with the general symptoms of acromegaly. AU of the symptoms named above are the result of a pathological condition caused by a malfunction of the pituitary gland. Progress has been made in modes of treatment recently, as the rich medical literature of the 1980s and early 1990s attests, with a whole group of researchers in France alone devoted to the study of acromegaly treatment with sandostatine and its analogues, octreotide and SMS 201-995.2 Oddly enough, however, the medical history of acromegaly goes back only to the nineteenth century, whereas literary evidence occurs as early as prebiblical myth. Symptoms of acromegaly, not only physical but also psychological, are in some sense described in Homer's depiction of Polyphemus and the biblical story of Goliath. It is modern medical literature, however, that now offers some practical explanations of giant lore in myth and folktale that often has been taken as pure fantasy. The giant is not as outrageous an example of the poetic imagination as one might have thought. We need not accept as gospel truth the thesis of the Abbé Henrion, an early eighteenth-century savant, that our ur-progenitors, * Special thanks are due to Esther Fritsch for drafting the footnotes and checking the paper for factual as well as typographical errors. Literature and Medicine 13, no. 2 (Fall 1994) 243-254 © 1994 by The Johns Hopkins University Press 244 THE GIANT IN LITERATURE AND MEDICAL PRACTICE Adam and Eve, were giants.3 Henrion thought that after the fall from the Garden of Eden men and women became smaller and smaller as a punishment for their sins. He claims that Adam must have been 130 feet tall, Abraham only 30 feet, Moses a mere 13. By this reading, the giants of old were considerably more gigantic than any acromegalic of the modern period. For our purposes, the East-African Watusi, at an average height of seven feet, are tall enough to qualify as giants. The clinical case in more temperate zones may be called acromegaly even if the patient is under six feet, not to speak of acromegaly in children. In acromegaly certain parts of the body grow inordinately: a height of over six feet is only one of the symptoms. The first well-known acromegalic identified in nineteenth-century medicine was not much over five feet tall.4 He evidenced a number of the telltale signs of interest to us here because the giant of myth and folklore also suffered from them. Thus, giant is a term referring to a constellation of conditions , of which height may be the most noticeable, though not a necessary one. In the following pages, I offer a medical and literary review of the myriad physical and psychological symptoms or effects of acromegaly that contribute to the making of a giant, a review that directly forces us to recognize the relation of art to life. The Acromegalic's Problems of Vision One complication that results from an enlarged pituitary gland is of special interest to the literary scholar: it may involve pressure on the optic nerves, which run from each eye past the pituitary gland, and on to the opposite side of the brain.5 If the pituitary gland becomes pathologically enlarged, the field of sight may narrow, either in both eyes or by way of blindness in one eye. And if a person is blind in one eye, what is...