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Prognosis - Addisons Disease and Other

classes, melasma and bronzing

PROGNOSIS - ADDISON'S DISEASE AND OTHER we have so far no certain evidence of the complete arrest or cure of any ease of this malady. Temporary improvement is all that can be looked for. Some of the chronic cases appear to last for five or six years. The average age at death is from thirty to thirty-five.

It is interesting to note that Addison's disease is rarely met with in the upper classes of society. Dr. Greenhow found that nine tenths of the cases occurred in the laboring classes. The mortality is almost entirely distributed over the laborious period of life, and males suffer much more than females.

These facts are held to indicate that injuries, strains, and falls have more to do with inducing the malady than is commonly believed, and the inability of the laboring classes to rest sufficiently and re cover soundly from such injuries may be also taken into considera tion. The majority of cases in females occur in hard-working servants and pool' married women. The following conclusions have been ar

rived at by Dr. Bedford Feuwick,' from an analysis of thirty cases recorded in the Pathological Society's Transactions, London, from 1866 to 1880: That cases without melasma usually die early, within five months, those with bronzing within two years from the first onset of symp that bronzing may be due to degeneration of the cortical layer, and the constitutional symptoms to implication of the medullary por tion, and that if the latter be mainly diseased or first involved the con stitutional symptoms may be rapidly developed and death occur be fore melasma takes place ; that if bronzing exists both adrenals are almost invariably involved, bat that in a distinct proportion of cases without melasma only one organ, and that generally the right, is affected. We have already discussed the conclusions just mentioned in respect of disease involving the cortex or medulla primarily.