1911 Encyclopædia Britannica/Hypertrophy

HYPERTROPHY (Gr. ὑπέρ, over, and τροφή, nourishment), a term in medicine employed to designate an abnormal increase in bulk of one or more of the organs or component tissues of the body (see Pathology). In its strict sense this term can only be applied where the increase affects the natural textures of a part, and is not applicable where the enlargement is due to the presence of some extraneous morbid formation. Hypertrophy of a part may manifest itself either by simply an increase in the size of its constituents, or by this combined with an increase in their number (hyperplasia). In many instances both are associated.

The conditions giving rise to hypertrophy are the reverse of those described as producing Atrophy (q.v.). They are concisely stated by Sir James Paget as being chiefly or only three, namely: (1) the increased exercise of a part in its healthy functions; (2) an increased accumulation in the blood of the particular materials which a part appropriates to its nutrition or in secretion; and (3) an increased afflux of healthy blood.

Illustrations are furnished of the first of these conditions by the high development of muscular tissue under habitual active exercise; of the second in the case of obesity, which is an hypertrophy of the fatty tissues, the elements of which are furnished by the blood; and of the third in the occasional overgrowth of hair in the neighbourhood of parts which are the seat of inflammation. Obviously therefore, in many instances, hypertrophy cannot be regarded as a deviation from health, but rather on the contrary as indicative of a high degree of nutrition and physical power. Even in those cases where it is found associated with disease, it is often produced as a salutary effort of nature to compensate for obstructions or other difficulties which have arisen in the system, and thus to ward off evil consequences. No better example of this can be seen than in the case of certain forms of heart disease, where from defect at some of the natural orifices of that organ the onward flow of the blood is interfered with, and would soon give rise to serious embarrassment to the circulation, were it not that behind the seat of obstruction the heart gradually becomes hypertrophied, and thus acquires greater propelling power to overcome the resistance in front. Again, it has been noticed, in the case of certain double organs such as the kidneys, that when one has been destroyed by disease the other has become hypertrophied to such a degree as enables it to discharge the functions of both.

Hypertrophy may, however, in certain circumstances constitute a disease, as in goitre and elephantiasis (q.v.), and also in the case of certain tumours and growths (such as cutaneous excrescences, fatty tumours, mucous polypi, &c.), which are simply enlargements of normal textures. Hypertrophy does not in all cases involve an increase in bulk; for, just as in atrophy there may be no diminution in the size of the affected organ, so in hypertrophy there may be no increase. This is apt to be the case where certain only of the elements of an organ undergo increase, while the others remain unaffected or are actually atrophied by the pressure of the hypertrophied tissue, as is seen in the disease known as cirrhosis of the liver.

A spurious hypertrophy is observed in the rare disease to which G. B. Duchenne applied the name of pseudo-hypertrophic paralysis. This ailment, which appears to be confined to children, consists essentially of a progressive loss of power accompanied with a remarkable enlargement of certain muscles or groups of muscles, more rarely of the whole muscular system. This increase of bulk is, however, not a true hypertrophy, but rather an excessive development of connective tissue in the substance of the muscles, the proper texture of which tends in consequence to undergo atrophy or degeneration. The appearance presented by a child suffering from this disease is striking. The attitude and gait are remarkably altered, the child standing with shoulders thrown back, small of the back deeply curved inwards, and legs wide apart, while walking is accompanied with a peculiar swinging or rocking movement. The calves of the legs, the buttocks, the muscles of the back, and occasionally other muscles, are seen to be unduly enlarged, and contrast strangely with the general feebleness. The progress of the disease is marked by increasing failure of locomotory power, and ultimately by complete paralysis of the limbs. The malady is little amenable to treatment, and, although often prolonged for years, generally proves fatal before the period of maturity.