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vomiting and pain in the region of the stomach; symptoms which have constituted a more or less prominent feature in every case that has fallen under my notice, and which in the present instance were so urgent as to suggest a suspicion of some acrid poison having been received into the stomach.
How far these gastric symptoms when present are referrible to sympathy existing between the diseased capsules and the stomach- how far they depend upon disturbed circulation within the head- how far they are attributable to accidental or essential gastric inflammation- and how far the inflammatory aspect of the gastric mucous membrane is the mere result of severe and repeated vomiting, a more extended observation will probably determine hereafter. It was from the presence of these gastric symptoms, the extreme and peculiar prostration of the patient’s strength, the great feebleness and smallness of the pulse, the anæmiated eye, the absence of any discoverable lesion to account for the patient’s condition, and more especially the dingy discoloration of the face, that led before death to a belief that we should on post-mortem examination find disease of the supra-renal capsules.
It is, moreover, of some significance and importance to observe, that in the present instance, the diseased condition of the supra-renal capsules did not result as usual from a deposit either of a strumous or malignant character, but appears rather to have been occasioned by an actual inflammation,- that inflammation having destroyed the integrity of the organs, and finally led to their contraction and atrophy.