A case of bronzed skin (melasma), without disease of the supra-renal capsules / by William Moore, M.D.

  • Moore, William, M.D.
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: A case of bronzed skin (melasma), without disease of the supra-renal capsules / by William Moore, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    Sydenham Society), if I am to judge from the picture, was not nearly so dark a case as mine. He accounts for the progressive character of the disease by the extensive deposit in the supra-renal capsule, keeping up a persistent irritation and exhaustion of the vaso-motor nerve. He'believes the vomiting is due to the irrita- tion of the branches of the pneumogastric nerve supplied to the gland, and the excessive prostration to the extension of the disease to the semi-lunar ganglion. In my case no such supra-renal deposit existed, and yet the symptoms of asthenia, vomiting, dementia, and bronzing of the skin, were progressive and persistent. Dr. Addison said if he saw a patient who presented this peculiar discolouration of the skin, he offered no explanation of as to how, why, or where it came. He observed associated with that disco- louration a certain train and combination of general symptoms, a pearly eye, a feeble pulse, a disposition of strongly marked anaemia, and a few other symptoms less constant and less urgent, and he then said, there is a case in which you will find disorganization of the supra-renal capsules, the body is examined, and no other organs are found diseased, and Dr. Wilks considers that what is more remarkable than the phenomena of the disease is the fact, that any other conclusion than Addison's can be arrived at concern- ing it; and further, he says, in most cases published to disprove the connexion between ' bronzing' of the skin and disease of the supra-renal capsules, the pigmentation has occurred in patches, and in others there can be little doubt that jaundice, pityriasis, ephelis, and ichthyosis have been mistaken for true discolouration. Now, every salient symptom alluded to by Addison was present in my case, whilst the bronzing of the skin did not occur in patches, and I can safely say it could not be mistaken for jaundice, pityriasis, ephelis, or ichthyosis; on the contrary, it was general, and to such an extent as to exceed any case I ever saw or read of, and yet there was no evidence of supra-renal disease. Viewing the case fairly, as far as our pathological and histological knowledge goes, it must be called a case of tuberculosis, but with no supra-renal disorganiza- tion. ' Guy's Ho.spital Reports, Vol. viii. Srd Series. I