condition of system is it which favours the production of black pigment? Is it some affection of the liver; or is it, as Dr. Addison supposes, disease of the supra-renal capsules?
The lining membrane of the stomach was finely injected into minute puncta and stellæ of a bright red colour, with two or three spots of ecchymosis. The structure of the membrane was thickened and pulpy, and the surface covered with tenacious mucus. In some parts there were irregular superficial abrasions; these appearances of the mucous membrane becoming very distinct by examining it under water by aid of sunlight, and seeming, moreover, unequivocally to demonstrate the existence of a gastritis. The brain, lungs, heart, spleen, liver and kidneys were normal.
The supra-renal capsules contained both of them compact fibrinous concretions, seated in the structure of the organ; superficially examined they were not unlike some forms of strumous tubercle. (Vide Pl. II. and Pl. VIII. figs 4, 5.)
The slow and insidious approach and progress of the constitutional loss of strength, the extreme feebleness of the pulse, the absence of all evidence of any lesion sufficient to account for the patient’s declining condition, the loss of appetite, the uneasiness and irritability of the stomach, and the indications of disturbed cerebral circulation, were all so strongly marked, and so exactly corresponded in kind with what have been observed to accompany the most extensive disease of the capsules, that, coupled with the excess of dark pigment in the integument, we did not hesitate to anticipate with much confidence an extensively diseased condition of these organs.