A case of Addison's disease / by William Pepper.

  • Pepper William, 1843-1898.
Date:
[1885]
Catalogue details

Licence: Public Domain Mark

Credit: A case of Addison's disease / by William Pepper. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    same in right ventricle; left ventricle in rigor mortis; left auricle contains a dark clot; valves healthy; no atheroma of intima of aorta : muscular substance a little rusty-brown in color; does not look fatty. On removal of heart, a very considerable amount of blood exuded from the veins. Liver.—Perfectly normal-looking, good color, and plenty of blood; the bile-vessels are normal. Stomach is very small; contains only bile-stained fluid; the cardia a little thin; mucous membrane normal. Kidneys.—Of average size; color good, except immediately be- neath enlarged capsules, where the tissue is soft, pale, and many of the tubes are fatty Intestines.—Cmcum and colon full of firm, hard scybala; ileum normal; Peyer’s glands distinct; two inches from caecum one long patch begins, which measures six inches in length, and presents in a typical manner the shaven-beard appearance ; the solitary glands are a little swollen and prominent. Bladder is full of urine ; the mesen- teric glands not swollen; the mesentery is very fat. Spleen.—Slightly enlarged; closely united to diaphragm and left supra-renal by old adhesions; pulp of medium consistency. Lymph-glands.—Some of the lymph-glands of the abdomen, par- ticularly those of the mesentery and retro-peritoneal, are swollen, grayish-red in color, and several of them contain grayish, translucent nodules, with opaque centres, looking like small tubercles; some as large as peas, and the centre distinctly caseous. Supra-renal Capsules.—The right is closely adherent to the kid- ney, diaphragm, and inferior cava, and to the liver above. It is two and a half inches in length, one and three-quarter inches in ver- tical diameter, and rests upon the top of kidney, not descending into the hilus. It is exceedingly hard and firm, and on section shows a peripheral, dense, grayish-white, partially translucent tissue, and centrally three or four yellow, caseous masses, separated from each other by strands of fibrous tissue of almost cartilaginous hardness. Left Capsule is much larger; covers the top of kidney, and de- scends on its inner surface well into the hilus, measuring three and a quarter inches in length, two inches vertical, and two and a half inches in thickness. The lower end of the spleen is firmly united to