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Addisons Disease

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ADDISON'S DISEASE.

Without doubt, the most important disease of the adrenal bodies is that now so well known, and generally recognized as "Addison's disease," a disorder which has received the other names, arising from the very noteworthy, and most usually associated symptom of skin-pigmentation, of melasma supra-renale and bronzed-skin disease. This disease was discovered by Addison some years before he pub lished his account of his cases, and was stumbled upon, * as it were, while he was endeavoring to detect the cause of certain fatal cases of anaemia which he encountered from time to time. These cases he tered " idiopathic" to distinguish them from ordinary ones which could be traced to more definite causes such as simple anaemia and chlorosis. These idiopathic cases we now recognize as examples of pernicious or grave anemia, a form of which is now treated with better success than formerly, although it constitutes always a very grave and often fatal disorder, a immopoietic failure. Such cases were indeed taken note of and recorded previously to Addison's researches, in particular by Channing, in New England, in 1842.

To use Addison's own words, "the leading and characteristic fea tures of the morbid state to which I would direct attention are, general languor and debility, remarkable feebleness of the heart's action, irritability of the stomach, and a peculiar change in color in the skin, occurring in connection with a diseased condition of the supra-renal capsules." This very concise definition is a mas terly one, and no better one can be given now, though forty years have elapsed since it was written.*

Since Addison's time, the disorders associated with his name have received full recognition in all parts of the world. It is happily not a common disease, and there is apparently reason to believe that it is more frequently encountered in hospital than in private practice, and is therefore less common among the upper and well-to-do classes of society.

In respect of its etiology, it is found to occur with far greater fre quency in males than in females ; according to Dr. Greenhow's in quiries, the relative proportion is as 119 to 64.

It has been met with at all ages from five to fifty years, but the majority of instances occur in men between thirty and fifty years of age.

It is not possible to discover that this malady was known to the older physicians. No descriptions sufficiehtly attest its definite recog nition, and no early museum specimens illustrating disease of the adrenals are known. Possibly the specimens in the Museum of Guy's Hospital from a case of Dr. Bright, placed there before 1846, are the earliest that have been preserved, though their real nature was unknown at the time. The discovery of these is due to Dr. Wilks. The adrenals were overlooked in early autopsies, and were not regarded with any special interest till Addison's researches led to more careful scrutiny of these organs.