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masses in the epidermic cells. The upper layers became gradually less coloured, until quite at the surface the colour was altogether absent. In some places similar pigment-granules were found in the true cutis, immediately below the epidermis. (See Plate, Fig. 1.)
OBJECT OF INVESTIGATION - COLLECTION OF CASES - ANALYSIS OF CASES - BRONZED-SKIN WITHOUT DISEASE OF SUPRA-RENAL CAPSULES - CANCEROUS DISEASE OF CAPSULES - MISCELLANEOUS DISEASES OF CAPSULES - IMPERFECTLY DESCRIBED OR DOUBTFUL CASES - CASES OF ADDISON’S DISEASE OF THE SUPRA-RENAL CAPSULES QUITE UNCOMPLICATED - ALMOST UNCOMPLICATED - WITHOUT EVIDENCE OF COMPLICATION - CASES WITH VERTEBRAL DISEASE OR LUMBAR ABSCESS - WITH TUBERCULAR DISEASE - WITH NON-TUBERCULAR DISEASE - SUMMARY OF ANALYSIS - NATURE OF MORBID CHANGE IN THE CAPSULES IN ADDISON’S DISEASE - ONE OR BOTH CAPSULES INVOLVED - CONDITION OF SUPRA-RENAL NERVES - SEAT OF DISCOLORATION - STATE OF BLOOD - DURATION, PROGRESS AND CHARACTER OF ILLNESS - INFLUENCE OF SEX, AGE AND OCCUPATION ON THE OCCURRENCE OF ADDISON’S DISEASE.
The three cases above described afford good illustrations of the difference in the effects produced on the constitutional health by different kinds of disease of the supra-renal capsules. In the first case, both the constitutional symptoms and the discoloration of skin characteristic of Addison’s disease being absent, no disease of the supra-renal capsules was diagnosed during life, and yet these organs were found after death to have been destroyed by cancer. In the two latter cases Addison’s disease was at once diagnosed when the patients came under treatment, by the peculiar train of constitutional symptoms with discoloration of skin, and the correctness of the diagnosis was verified after death by examination of the supra-renal capsules. There are now a great many instances on record, in which the same circumstances have occurred as in these two latter cases; but yet it appears, from occasional discussions and publications, that
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* Reprinted from the Transactions of the Pathological Society,
Vol. xvii., p. 310.