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At the post-mortem examination, the lungs were found firmly attached to the ribs by fibrous adhesions. Deposits of yellow cheesy matter were found in the apices of both lungs, and these deposits were surrounded by dark consolidated tissue intersected by fibrous bands; the lungs were everywhere else perfectly crepitant. There was recent pericarditis; and the right cavities of the heart were filled with firm masses of yellow semi-transparent fibrine, adherent to the musculi pectinati and the chordæ tendineæ, and passing into the pulmonary artery as far as the second division. A similar but smaller coagulum was found also in the left ventricle, passing for a short distance into the aorta. The great omentum was firmly adherent to the diaphragm, and the gall-bladder to the small intestine. The under surface of the diaphragm, the surface of the mesentery, and the peritoneum in front of the spine, were studded with patches of grey, tubercular granules, surrounded by deposits of black pigment. Peyer’s glands were normal. The kidneys were slightly granular.

Both supra-renal capsules were enlarged and nodulated, the right being much the larger. The fibrous envelopes were much thickened, and that of the right capsule was firmly adherent to the diaphragm. On section, no traces of cortex or medulla were discoverable; the whole of both organs had been converted into a material which, to the naked eye, had precisely the appearance of tubercle.

Under the microscope, a section of one of the discoloured patches from the tongue shewed deposits of brown pigment, arranged in irregular masses in the papillæ, the superficial layers of epithelium covering them being quite free from discoloration. I may here observe that the deposit of pigment, which caused the discoloration of Addison’s disease, is situated, as a rule, entirely in the rete mucosum, the epidermis and the true skin remaining unchanged.*

You will have observed that this case presents the same general features as the former one; namely, gradually progressive asthenia and gastric irritability, attended by discoloration of the skin and of the mucous membranes of the mouth. The black discoloration round the patches of tubercle on the peritoneum, I believe to have been in no way connected with the disease in the supra-renal capsules, for the same appearance has often been observed in chronic tubercular affections of the peritoneum, in cases in which the supra-renal capsules have been found quite healthy. Indeed, several foreign writers are of the opinion that the discoloration found in Addison’s disease is due, not to the