respecting them. But if the obscurity, which at present so entirely conceals from us the uses of these organs, justifies the feeblest attempt to add to our scant stock of knowledge, it is not less true, on the other hand, that any one presuming to make such an attempt, ought to take care that he do not, by hasty pretensions, or by partial and prejudiced observation, or by an over-statement of facts, incur the just rebuke of those possessing a sounder and more dispassionate judgement than himself. Under the influence of these considerations I have for a considerable period withheld, and now venture to publish, the few facts bearing upon the subject that have fallen within my own knowledge; believing as I do now, that these concurring facts, in relation to each other, are not merely casual coincidences, but are such as admit of a fair and logical inference- an inference, that where these concurrent facts are observed, we may pronounce with considerable confidence, the existence of diseased supra-renal capsules.
As a preface to my subject, it may not be altogether without interest or unprofitable, to give a brief narrative of the circumstances and observations by which I have been led to my present convictions.
For a long period I had from time to time met with a very remarkable form of general anæmia, occurring without any discoverable cause whatever; cases in which there had been no previous loss of blood, no exhausting diarrha, no chlorosis, no purpura, no renal, splenic, miasmatic, glandular, strumous, or malignant disease. Accordingly, in speaking of this form of anæmia in clinical lecture, I, perhaps with little propriety, applied to it the term idiopathic, to distinguish it from cases in which there existed more or less evidence of some of the usual causes or concomitants of the anæmic state.
The disease presented in every instance the same general character, pursued a similar course, and, with scarcely a single exception, was followed, after a variable period, by the same fatal result. It occurs in both sexes, generally, but not exclusively, beyond the middle period of life, and so far as I at present know, chiefly in persons of a somewhat