sponding condition. Whether any, or all, of these morbid changes are essentially concerned, as I believe they are, in giving rise to this very remarkable disease, future observations will probably decide.
The cases having occurred prior to the publication of
It was whilst seeking in vain to throw some additional light upon this form of anæmia, that I stumbled upon the curious facts, which it is my more immediate object now to make known to the Profession; and however unimportant or unsatisfactory they may at first sight appear, I cannot but indulge the hope, that by attracting the attention and enlisting the cooperation of the Profession at large, they may lead to the subject being properly examined and sifted, and the enquiry so extended, as to suggest, at least, some interesting physiological speculations, if not still more important practical indications.
The leading and characteristic features of the morbid state to which I would direct attention, are, anæmia, general languor and debility, remarkable feebleness of the heart’s action, irritability of the stomach, and a peculiar change of colour in the skin, occurring in connexion with a diseased condition of the “supra-renal capsules.”
As has been observed in other forms of anæmic disease, this singular disorder usually commences in such a manner, that the individual has considerable difficulty in assigning the number of weeks or even months that have elapsed since he first experienced indications of failing health and strength; the rapidity, however, with which the morbid change takes place, varies in different instances. In some cases the rapidity is very great, a few weeks proving sufficient to break up the powers of the constitution, or even to destroy life; the result, I believe, being determined by the extent, and by the more or less speedy development, of the organic lesion. The patient, in most of the cases I have seen, has been observed gradually to fall off in general health; he becomes languid