On Addison's disease : clinical lectures on Addison's disease and a report on diseases of the supra-renal capsules / by Edward Headlam Greenhow.

  • Greenhow, Edward Headlam, 1814-1888.
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: On Addison's disease : clinical lectures on Addison's disease and a report on diseases of the supra-renal capsules / by Edward Headlam Greenhow. Source: Wellcome Collection.

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    EXTERNAI, SIGNS. on the ali-eadj' discolom-cd skin. Although the discoloration is gene- rally most mai'ked on certain parts of the body, and may even exist on some parts while the skin of other pai-ts is of the normal hue, there is rarely, or never, any definite Hue of demarcation between the dis- coloured and normal portions of the skin ; but the former fade insen- sibly into the latter. The characteristic discoloration is not restricted to the skin, but, in weU-marked cases, is also usually found upon the lips in the form of an irregular stain running lengthwise, and upon the gums and buccal mucous membrane in the form of stains or patches ; these last may, perhaps, when present, be considered as the most deci- sive of the external diagnostic signs of Addison's disease. It is, on the other hand, important to remark that the conjunctivae always remain uncoloured, and in the more deeply discoloured cases theii* pearly whiteness presents a striking contrast to the dusky hue of the face. I may mention, by the way, that this discoloration of the gums and buccal mucous membrane afi'ords another analogy between the disco- loration of Addison's disease and the natirral colour of the darker races; two Hindoos who were hospital out-patients of mine having presented dark stains on those parts, exactly resembling the stains found in cases of Addison's disease. Moreover, in one of them I noticed that some superficial cicatrices were of a darker shade than the surrounding integument.* We have had in the hospital, during the last year, two well-marked * While these sheets are passing through the press, I have received, from Dr. Balthazax Foster of Binmngham, the notes and photograph of a most remarkable case, in which the irritation of blisters has caused renewed deposits of dark pig- ment in the skin of a mulatto who has for some years been gradually turning white. A mulatto aged 43, the child of an escaped negro slave by an English mother, about sis years ago began to change colour; his wife first noticed white specks on his back, which gradually coalesced and spread until the whole trunk became white; the upper parts of the legs and arms then became spotted with white patches, and the limbs are at this time in great part white, though less so towards the hands and feet which remain dark. The white colour terminates half-way up the neck and the face remains dark, with ordinary mulatto features and black crispy hair; spots of white are appearing, however, on the right side of the fore- head and at the angles of the jaw. The white skin is soft and healthy, not to be distinguished from that of a European. The man had good health up to three or four years back, but has since been aUing, apparently in consequence of intemperate habits. He suffers from bronchitis, and on each occasion that a blister has been applied to the surface, it has sufficed to reproduce, in the white skin, several irregular spots of the original dark colour, which have hitherto