SUPRA-RE'NAL CAPSULES AND THEIR DISEASES. The supra-renal capsules are two small, flattened, glandular bodies of a yellowish color, situated, as their name implies, immediately in front of the upper end of each kidney. In weight they vary from one two drams. They belong to the class of ductless glands, and on making a perpendicu lar section, each gland is seen (like the kidney) to consist of cortical and medullary sub stance. The blood-vessels and nerves of the glands are exceedingly numerous. Of late years much attention has been drawn to the diseases of these organs from the observation of the late Dr. Addison (of Guy's hospital), that such cases are frequently associated with the deposition of pigment in the skin, causing it to assume a deep bronze color. The following definition of Addison's disease, or melasma, or bronzed skim. disease, embracing all the most important points in its natural history, is given by Dr. Aitken : "A morbid state which establishes itself with extreme insidiousness, whose characteristic features are anmrnia, general languor and debility, and extreme prostration, expressed by loss of muscular power, weakness of pulse, remarkable feebleness of the heart's action, breathlessness upon slight exertion, dimness of sight, functional weakness and irritability of the stomach, and a peculiar uniform discoloration of the skin, which becomes of a brownish olive-green hue, like that of a mulatto, occurring in connection with a certain diseased condition of the supra-renal capsules. The progress of the
disease is very slow, extending on an average over one year and a half, but may be pro longed over four or five. The tendency to death is by asthenia, the heart becoming utterly powerless, as if its natural stimulus—the blood—had ceased to act."—The &fears and Practice of Medicine (3d. ed. vol ii. p. 72), The numerous cases recorded by differ ent physicians of all countries since Dr. Addison's original observations were made, show that the connection between bronzing of the skin and various morbid states of the supra-renal capsules is a fact beyond all dispute; but the exact relationship and patho logical significance of the morbid states thus connected are still open questions. 'Di; special morbid changes in the capsules necessary for the production of the symptoms which constitute the disease, are first the deposition of a translucent, softish substance; the degeneration of this to a yellowish-white opaque matter; and afterward a softening into an abscess, or drying up into a chalky mass. In the way of treatment, nothing can be done but attempt to improve the general health by nourishing food, tonics, etc. The literature of this very singular disorder is mainly to be found in various memoirs in the Guy's hospital Reports.