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consisted almost entirely of oil and granular debris, and did not appear to be true pus. The characters of the left capsule were very similar, but the tubular structure was much more obscured.
Microscopical examination of slices from the discoloured patches on the tongue, shewed deposits of pigment in the form of irregular brown masses deposited in the papillæ, the superficial layers of epithelium covering them being quite free from colouring-matter. (See Plate, Fig.2.)
CASE III.- Addison’s disease of the supra-renal capsules.
C. S., aged 32, coal-porter, was admitted into the Middlesex
Hospital, under the care of
He stated that his health had been good until it began to fail, about eight or nine months previous to his presenting himself at the Hospital for admission. Upon inquiry, however, it was subsequently elicited that somewhat more than three years before he had sprained his back severely in pushing a loaded coal-truck, and had experienced at that time a sensation of something giving way. He had ever since suffered more or less constantly from pain in the region of the lower dorsal vertebræ, for the relief of which he had tried various remedies including blisters. Eight or nine months before his admission he had begun to suffer from debility, sweating, headache, loss of appetite, and sickness, with breathlessness on exertion, followed by severe pain in the right lumbar region. Four or five months later, his wife had observed a change of colour, which she thought appeared first upon the face and hands, and which gradually deepened, and spread over the whole body. He had been compelled to give up work for about two months.
On admission, his skin was of a general olive-brown hue, especially on the face and neck. On the face were several almost black specks; there was a stain on the right side of the tongue, and the lips and buccal mucous membrane were mottled with brown. The upper part of the chest and the legs were lighter in colour than the rest of the body; the abdomen was darker than any part except the sites of blisters, which had been applied over the right flank and lumbar vertebræ some months previously. The nipples and areolæ, the penis and scrotum were very dark; the hands, and especially the knuckles, were much darker than the arms. The hair and beard were said to have become visibly darker during his illness. The white pearly hue of the