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may add that the naturally brown hair of a young woman who is still under my care, suffering from Addison’s disease, has become of a raven-black colour and coarser in texture, since she first came under observation more than a year ago.

State of the blood.- The blood seems to have been very rarely examined in cases of Addison’s disease. In one case pigment is said to have been found in the blood, and, in the same case, it was found also in the spleen; in a few cases the white corpuscles of the blood are said to have been in excess; in one or two, the blood is reported to have been normal, and in one of two others the red corpuscles were certainly not deficient. Dr. Hayden says that the white corpuscles have been found in excess in all the cases in which the blood has been examined, but in support of the assertion he only adduces two cases, and my experience certainly does not confirm his view. Professor Dr. Buhl, on the other hand, considers that in Addison’s disease, there is always great deficiency of fibrine in the blood, but he has evidently founded his opinion on cases in which there was also disease of the spleen, and his experience as to the fluid state of the blood and the entire absence of clots after death is altogether opposed to the general evidence on this point. In every case in which I have witnessed the post-mortem examination, firm, discoloured fibrinous clots were found in the right cavities of the heart, attached to the musculi pectinati and chordæ tendineæ, and passing sometimes for a considerable distance into the pulmonary artery. Similar clots in the right ventricle are reported in a large number of the cases, and less frequently as existing also in the left ventricle, but I regard them, at least in this disease, as mere consequences of the usually slow mode of death. As yet, however, no satisfactory conclusions can be drawn from the hitherto insufficient investigations into the condition of the blood in cases of Addison’s disease.

Duration and course of illness.- The commencement of Addison’s disease can but rarely be referred to any particular date, and patients can seldom fix any definite time for the commencement of their symptoms, so that in the present state of our knowledge it is scarcely ever possible to determine, with accuracy, the actual or comparative duration of the local disease and its external manifestations. Moreover, even in those cases in which the duration of the illness is exactly specified, no great reliance can be placed upon the correctness of the reports, for the disease is infinitely more frequent among the labouring classes, who usually date the commencement of an illness

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