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Monday, December 29, 2014

THE BIBLICAL GIANT


The Giants have been around since time began; they are first described in the Bible in the book of Genesis (6:1-4)1. Originally, giants appear to have been regarded positively, often considered as heroes, particularly by the non-Hebrew population. After the great Flood, giants remained present in the scriptural texts, but their good reputation had waned in the eyes of the Hebrews, and they often tended to be seen as the enemy, often fighting in armies. Giants lived together as a number of separate races, before and after the Flood. The exact relations between different families of giants are a little unclear. For example, the Nephilim (Numbers 13:32-33), appear to be present before and after the flood. The Emites, the Ammonites (or Anakites) and the Rephaim (Deuteronomy 2:10-11), existed after the Flood and appear to be separate entities although the chronicler often uses the phrase ‘like’ suggesting they had a similar phenotype. The Anakim seem to be derived from the Nephilim. The Rephaim although similar to the Nephilim, appear to be distinct from them with respect to family lineage. Deuteronomy 2.21 states the Rephaim were largely subdued by the Ammonites which ‘dwelt in their stead’ One of the most prominent Rephaim was Og, King of Bashan, who slept in ‘a bedstead of iron; nine cubits was the length, and four cubits the breadth of it’ (Deuteronomy 3:11). A cubit was the distance from the elbow to the fingertips. He appears to be one of the last survivors of the Rephaim. A race of giants implies a hereditary element and the origins of some names may indicate the genetic pathway involved. The Hebrew word anaq may mean necklace (Proverbs 1:9), or possibly goitre. This could suggest hyperthyroidism, possibly due to underlying pituitary gland, or other endocrine, dysfunction.

Gigantism, also known as giantism (from Greek γίγας gigas, "giant", plural γίγαντες gigantes), is a condition characterized by excessive growth and height significantly above average. In humans, this condition is caused by over-production of growth hormone in childhood resulting in persons between 2.13 m (7 feet or 84 inches) and 2.74 m (9 feet or 108 inches) in height.

The term is typically applied to those whose height is not just in the upper 1% of the population but several standard deviations above mean for persons of the same sex, age, and ethnic ancestry. The term is seldom applied to those who are simply "tall" or "above average" whose heights appear to be the healthy result of normal genetics and nutrition. Gigantism is usually caused by a tumor on the pituitary gland of the brain. It causes growth of the hands, face, and feet. In some cases the condition can be passed on genetically through a mutated gene.

Other names somewhat obsolete for this pathology are hypersoma (Greek: hyper over the normal level; soma body) and somatomegaly (Greek; soma body, genitive somatos of the body; megas, gen. megalou great). In the past, while many of them were social outcasts because of their height, some (usually unintentionally) found employment in Friedrich Wilhelm I's famous Potsdam Giants regiment.

Many of those who have been identified with gigantism have suffered from multiple health issues involving their circulatory or skeletal system.

Hypersecretion of growth hormone causes gigantism in children and acromegaly in adults. Evaluation of growth hormone hypersecretion cannot be excluded with a single normal GH level due to diurnal variation. However, a random blood sample showing markedly elevated GH is adequate for diagnosis of GH hypersecretion. Additionally, a high-normal GH level that fails to suppress with administration of glucose is also sufficient for a diagnosis of GH hypersecretion.

Insulin-like Growth Factor-1 (IGF-1) is an excellent test for evaluation of GH hypersecretion. It does not undergo diurnal variation and will thus be consistently elevated in GH hypersecretion and therefore patients with gigantism. A single normal IGF-1 value will reliably exclude GH hypersecretion.

Reports of gigantism exist throughout history, with some nations and tribes taller than others. The giants of Crete are listed in various historic sources, beginning with Titan, a Greek mythological giant, and including Gigantus, after whom giants and gigantism are named.Rhodes is another island where giants were said to have lived, with the Colossus of Rhodes, a giant statue of a giant patron god Helios.Goliath, a giant mentioned in the Bible, was a Philistine warrior who was slain by David in a battle between the Israelites and the Philistines. A member of Goliath's family is also recorded as having six fingers on each hand and six toes on each foot.

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