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ence of reference, together with the name of the reporter, of the publication from which the report was taken, and also that of the medical attendant on the case, when not himself the reporter. Then follow in order, in the subsequent columns, the sex, age and occupation of the patient, the previous history and duration of the illness, the symptoms, the colour of skin, and lastly, the results of the post-mortem examination, both as to the state of the supra-renal capsules and as to the condition of other organs.
Analysis of cases.- At the outset of my examination I found that the cases would naturally fall into two prima facie groups; viz., first, those cases which presented a certain train of symptoms briefly described by Dr. Addison, attended almost always by discoloration of skin, and second, those cases in which the said symptoms were absent. These peculiar symptoms, together with the discoloration of skin, are well exemplified in cases II. and III. prefixed to this paper.* On carefully analyzing the cases I had collected, it appeared not only that a very large proportion of them belonged to the first of these groups, but also that in all the cases in that group, and, with a very few exceptions, in no others, the supra-renal capsules were reported to have undergone a morbid change entirely analogous to that described in the two cases of Addison’s disease at the head of this paper.
This further fact rendered the whole number of cases finally divisible into two categories. The one comprehends all those cases, one hundred and twenty-eight in number, in which there had clearly taken place in the supra-renal capsules the morbid change characteristic of Addison’s disease, and coincides generally, as I have said and the following analysis will shew, with the presence of the symptoms of Addison’s disease during life. The other includes all the remaining cases of morbid change in the supra-renal capsules of whatever description, as well as the cases of bronzed skin without any change in the supra-renal capsules; and from these, as will be seen, with a few explainable exceptions, the symptoms of Addison’s disease were altogether absent. Lastly, I have been obliged to place in this second category, a number of cases in which the change in the capsules was so imperfectly described, or appeared from the description to be of so doubtful a character, that it was impossible fairly to class them with the genuine cases. These miscellaneous groups in the second division amount, in the aggregate, to sixty-eight cases, and I shall first briefly deal with them, before proceeding
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* For a full description of the symptoms and discoloration of
Addison’s disease, see also “Constitutional symptoms,”
and “External signs,” at pp. 3 and 4.