On disease of the supra-renal capsules, or morbus Addisonii / by Samuel Wilks.

  • Samuel Wilks
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: On disease of the supra-renal capsules, or morbus Addisonii / by Samuel Wilks. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    57/68 page 53
    blue areola; conjunctiviB of a pearly white colour; the pulse was extremely feeWe, and the urine dribbled away. He had lost flesh, and the muscles were flabby, but a stethoscopic examination of the chest produced no evidence of pulmonary disease. It appeared, from the statement of the mother, that he began to droop about four months previously, became tired and inclined to sleep. Before these symptoms were remarked he was very stout, with a very fresh colour and clear skin. Two months after the eyes were observed to sink in his head, the appetite failed, and nausea supervened, which was followed by vomiting. The skin became yellow, and afterwards bronzified. The doctors said it was jaundice or liver. The water soon began to dribble, with wasting of the body and drowsiness. He used to fall asleep, and was roused with difiiciilty; he complained frequently of great pain in the back, pit of the stomach, and on the clavicles, with extreme feebleness. The vomiting ceased during the use of efl'ervescing medicine, and the pain iu the back, with the dribbling of water, subsided while he took steel combined with other tonics. But nothing seemed to relieve his extreme debility and flabby state of the body, cod-liver oil being tried to no purpose. At length his feebleness became so urgent that I recommended him to be placed under the care of Dr. Addison, at Guy's Hospital, believing that be suffered from disease of the supra-renal capsules, and I sent a message to that efl'ect to Dr. Addison, who replied that I was right in my opinion. The lad only survived three days, and during this time he was often delirious and had slight convulsive attacks. Pont-mortem examination.—Body spare, but not wasted, and having a moderate amount of integumental fat in all parts. It was universally discoloured, being of a brown hue, and uniformly so, no parts being unaffected, except the palms of tlie hands and the soles of the feet. Tiiere was a greater intensity of colour over the back of hands and feet, especially over the joints, but there were no defined patches in any part. There was also a little pigment-deposit on the lips. The colour on the body was of a light brown, and so universal that, unless the contrary had been known, the boy might have been looked upon as a native of some southern climate, or, at all events, as having some dark blood in him. The body was opened, and no disease was found in any part save the supra-renal bodies. There were no tuliercles in the lungs, nor was there any evidence of scrofulous affection elsewhere. Peyer's patches in small intestine were much raised, and the solitary glands were very distinct. The supra-renal bodies were both diseased in the usual manner. They were slightly larger than natural, and were wholly converted into a tough, yellow, amorphous matter, interspersed with some grayer and more translucent substance. There was not a trace of the original tissue to be found, and the change must have been progressing for a very long period. There was no chalky matter present. [Preparation, Skin, 1641 ^. Wax Models, 246 > ^.'] Case 19.—The following case^ occurred in the country, in the practice of Dr. Houseley, of Worsop, near Mansfield, a stranger to our hospital, and a perfectly independent observer, but, struck with the remarkable nature of the case he was ' Published in the ' Lancet,' July 28th, 18G0.
    digitised image 1
    digitised image 2
    digitised image 3