Case in which autopsy revealed con genital absence of the suprarenal cap sules. No other lesions were found. Only two similar cases reported. Patient was 24 years old; the symptoms were melanoderma, pains, progressive asthenia, wasting, cachexia, and gastrointestinal disturbance. Ended fatally in ten months. A. Rispal (Third French Med. Cong.; N. Y. Med. Record, Sept. 19, '97).
Case of Addison's disease with simple atrophy of the adrenals in which, though the histological changes were compara tively slight, the symptoms of Addison's disease were well marked and fatal. The cutaneous pigmentation appeared four teen years before the onset of the pro found constitutional symptoms. Carlin Philips (Jour. of Exper. Med., vol. iv; Practitioner, May, 1900).
Prognosis. — Until very recently the prognosis in well-characterized cases of Addison's disease has been uniformly regarded as unfavorable. It is true that a very few cases of recovery have been reported, but nearly all writers of the highest authority regard such as ex amples of mistaken diagnosis. "An
absolutely fatal prognosis must always be made. In all these cases which are recorded as having been cured there exists a doubt as to the accuracy of the diagnosis." (Merkel.) Osler, in 1894, declared that the dis ease was fatal in every case. In the meantime, encouragement by the results of the use of the thyroid gland or ex tracts from the same in cases of acrome galy led Oliver and others to use extract of the healthy suprarenal capsules in the. treatment of Addison's disease, and with so much benefit that in the second edition of his work, in 1895, Osler had modified his previous declaration by saying: "The disease is usually fatal. . . . In rare instances recovery has taken place, and periods of improvement,. lasting many months, may occur." Case of recovery in a man of 57 years who, in April, 1SS5, was suddenly at tacked by weakness, ancemia, pigmenta tion of the mucous membranes, bronzed skin, and, a little later, pain in the re gion of the capsules. Strength returned little by little; so that in September,