MELASMA

165

He had begun to droop about four months previously; up to that time he had been stout, with a fresh colour and clear skin. He was admitted into Guy`s Hospital on August 17th, 1859, and he died on the 20th.
On post-mortem examination the body was found to be spare, but not wasted. It was universally of a brown hue, no parts having escaped except the palms and soles. There was a little pigment in the mucous membrane of the lips. The supra-renal bodies were slightly enlarged and "wholly converted into a tough, yellow, amorphous matter, interspersed with some greyer and more translucent substance."
See Dr. Wilks` paper in the `Guy`s Hospital Reports,` series iii, vol. viii, p. 52.

See also prep. of the skin 164140, and model of the supra-renal capsules.

	MELASMA SUPRA-RENALE. Two models (360 and 361) from a patient affected with this disease.

360.	Model of the two nipples and of the adjacent parts of the skin. The nipples and areolæ are of a deep-brown or almost black colour. The rest of the skin is pale brown.

361.	Model of the right leg and foot of the same patient. There is much distortion of the ankle, which was supposed to have been caused by disease of the joint. The skin is of a dark brown colour, especially about the external malleolus.

	Wm. J- æt. 25, was first admitted into the hospital on November 22nd, 1860, under Dr. Gull, who then recognised that he was suffering from Addison`s disease. It had been noticed two years previously that his skin was getting dark, and during the seven months which preceeded his admission this had much increased. He also suffered from debility, vomiting, &c. Sometimes when he first rose after lying down his sight became dim. His face was of a warm brownish tinge. The lips presented a dark line where they touched. The upper limbs were paler. The abdomen was very dark. The legs were less dark than the thighs He was in the hospital on repeated occasions. He had something the matter with his left foot, which at one time caused him much pain. He was admitted for the last time on September 3rd, 1865, and died on September 25th. He was then very brown, the nipples being of an especially deep colour. The lower extremities were also much discoloured, especially the legs. The post-mortem examination was made by Dr. Fagge. The body was not emaciated, there being a good quantity of fat beneath the skin and in the visceral cavities. The brain was healthy. Each lung contained some calcareous

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	He had begun to droop about four months previously; up to that time he had been stout, with a fresh colour and clear skin. He was admitted into Guy`s Hospital on August 17th, 1859, and he died on the 20th. On post-mortem examination the body was found to be spare, but not wasted. It was universally of a brown hue, no parts having escaped except the palms and soles. There was a little pigment in the mucous membrane of the lips. The supra-renal bodies were slightly enlarged and "wholly converted into a tough, yellow, amorphous matter, interspersed with some greyer and more translucent substance." See Dr. Wilks` paper in the `Guy`s Hospital Reports,` series iii, vol. viii, p. 52. See also prep. of the skin 164140, and model of the supra-renal capsules.