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.

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    mark of this form of autemia is the singular clingy or dark discoloratiou of the skin; Bcvertheless, at a very early period of the disorder, and when the capsules are less extensively diseased, the discoloration may doubtless be so slight and equivocal, as to render the source of anaemic condition un- certain. Our doubt, in such cases will have reference chiefly to the sallow, anaemic condition, resulting from miasmatic poisoning, or malignant visceral disease; but a searching in- quiry into the history of the case, and a careful examination of the several parts or organs usually involved in anaemic disease, will furnish a considerable amount of at least negative evidence; and Avhen we fail to discover any of the other well- known sources of that condition, when the attendant symptoms resemble those enumerated, or accompanying disease of the capsules, and when to all this is superadded a dark, dingy, or smoky looking discoloration of the integument, we shall be justified in entertaining a strong suspicion in some instances, almost amounting to certainty in others. It must, however, be observed, that every type of yellow or mere sallowness throws a still greater doubt over the true nature of the case, and that the more decidedly the discoloration partakes of the character described, the stronger ought to be our impression as to the capsular origin of the disorder. Analysis of symj^toms.—We will now analyse some of the symptoms above referred to, as well as others which have been subsequently observed. Asthenia.—I cannot too much impress upon the reader the above characteristic description, given by the discoverer, in order that he may not be misled by some of the mistaken views of the subject which have now and then appeared in print; as, for example, that Addison had alluded to an ordinary debility, with emaciation, Avhen he described the constitutional symi)- toras of the disease. Emaciation, it must be remembered, is not a necessary accompaniment of asthenia; and thus supra- renal affection is not to be sought for in those who, without any apparent reason, are wasting away. Some writers, how- ever, have used the term emaciation as if it had been almost synonymous with want of power, even when wasting did not really exist; for we find cases spoken of where emaciation was present, and yet after death the body is described as covered
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