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of these, the two last (Nos. 33 and 34), reported by Drs. Mettenheimer of Frankfort and Duclos of Tours were manifestly, from the descriptions, cases of Addison’s disease and not of cancer. In neither of these cases does there appear to have been any microscopical examination to determine the character of the morbid product, and Dr. Mettenheimer, at least, was so little clear on this point as to state that were “either tuberculous or cancerous indurations in the left lung.” He merely reports that the places of the supra-renal capsules were occupied by cancerous deposit; but, in the fuller description of Dr. Duclos, the condition of the supra-renal capsules exactly coincides with that characteristic of Addison’s disease and by no means with that usual in cancer of those organs. They are said to have been hard and nodulated, to have grated in places against the scalpel, and to have presented precisely the appearance of lardaceous tissue. Moreover, in order to accept as correct the report of cancer in these cases, we must admit that primary cancer had commenced simultaneously, and proceeded pari passû, in the two symmetrical organs, which is certainly a most unusual, if not absolutely unknown, occurrence in the history of cancer. Finally, these are the only two out of the twenty-four reported cases of cancer which were accompanied either by the train of constitutional symptoms or by the peculiar discoloration of skin characteristic of Addison’s disease, an incredible circumstance, if cancer of the supra-renal capsules could really produce the same effects as Addison’s disease of those organs. Of the twenty-two other cases of cancer not one presented anything resembling the train of constitutional symptoms of Addison’s disease; seven only, including the four reported by Dr. Addison himself, are said to have been more or less discoloured, and, even in these, such discoloration as there was appears to have been quite uncharacteristic. The history of many of these cases is most imperfectly given, and they have, apparently, been published with no other view than that of shewing, that in cases of cancer of the supra-renal capsules there either was, or was not, discoloration of skin supposed to be analogous to that characteristic of Addison’s disease. The accumulated evidence of these twenty-two cases proves, in my opinion, conclusively, that cancerous disease of the supra-renal capsules does not produce either the aggregate of symptoms or the peculiar discoloration of skin incident to Addison’s disease of those organs. That Dr. Addison himself should have been mistaken at this point, and should at first have believed that any morbid change in the structure of the supra-renal capsules would suffice to produce

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