Cases of diseased supra-renal capsules were related by various authors
previous to Dr. Addison, but, until he did so, no one
had connected any particular symptoms with disease of these organs.
These symptoms are, nevertheless, so striking and peculiar that
they could not fail to have been observed, though their nature
was not understood. Accordingly, several observers had described cases
of Addison’s disease, more or less accurately, long before
the publication of Dr. Addison’s
discovery of its connection with a morbid lesion of the supra-renal
capsules. Thus, Risel relates an almost
typical case which was recorded by Dr. Schotte
in the "Halle Hospital Reports" for 1823, * and
Dr. Bright described a case in 1831 † which
is quoted as a true case of this disease by Dr. Addison
in his monograph.‡
Dr. Addison appears to have communicated his views
on the constitutional and local effects of disease of the supra-renal
capsules to the South London Medical
Society several years before the publication of his more
complete treatise in 1855, but this earlier communication seems to have
attracted little attention. Since the latter date, very numerous cases
of the disease have been observed and recorded both in England and abroad,
and although, as has so often been the case with other scientific
discoveries, much scepticism was for many years entertained as to the
relation subsisting between the constitutional symptoms and the local
lesion in the supra-renal capsules, no one now, I believe, doubts the
reality of this relation. My purpose in this paper being only to explain
the present state of our knowledge on the subject, I shall now pass at
once to the consideration of the disease itself, and will commence by
relating a hitherto unpublished case, as being the most convenient mode
of bringing the phenomena of this disease prominently before my hearers.
M. W., aged eighteen years, needlewoman, was admitted into the Middlesex
Hospital under my care, December 12, 1876. She stated that, with the
exception that the catamenia were not quite regular, her health had
always been excellent until about five weeks previous when she had a
severe attack of bilious vomiting, and observed that her face, arms,
and hands had acquired a dark yellow colour. The vomiting continued
to recur after meals for several days. She nevertheless gradually
recovered from this slight illness and was in her usual health on the
evening of December 9. On rising next morning she experienced pains in
the knees and legs and at the lower part of the spine was very chilly
during the day, and had a severe rigor in the evening. Next day the
pain in the back
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* Deutsche Archiv f. klin. Med., Vol. vii. p. 46.
† "Reports on Medical Cases," vol. ii. p. 247.
‡"On the Constitutional and Local Effects
of Disease of the Supra-Renal Capsules," by Thomas Addison,
Physician to Guy’s Hospital.
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