Chapter XXI 



ADDISON'S DISEASE 



Thomas Addison's 7 treatise "On the Constitutional and 

 Local Effects of Disease of the Suprarenal Capsules" published 

 in 1855, is one of the classics of medical literature. His publi- 

 cation initiated the modern study of the adrenal glands and 

 remains today, from a clinical standpoint, almost complete in 

 its accurate description of the disease. 



Addison's observations were soon confirmed by Wilks, 681 

 Greenhow, 242 Hutchinson, Isaac Taylor, and Trouseau. 640 The 

 last named author first applied the term "Addison's Disease" 

 in 1856. Addison's original conception of the disease was the 

 one which is generally accepted today: viz., that any lesion of 

 the adrenals sufficient to interfere with their function would 

 give rise to the train of symptoms characteristic of the disease. 

 This view, however, soon became the subject of criticism by 

 Addison's contemporaries who considered the disease as origi- 

 nating from a special lesion of the glands which resulted in 

 secondary effects on the neighboring sympathetic nerves and 

 ganglia. Addison also was led to alter his original views and 

 to regard an involvement of the sympathetic system as a con- 

 tributing factor in causing the disease. This "nervous" theory 

 of the origin of the disease was in time abandoned when it was 

 found that in many cases of genuine Addison's disease there 

 was no involvement of the sympathetic system. 



Wilks, 681 who studied the pathological anatomy of Addison's 

 first patients, reported in 1865 a total of 33 cases which he con- 

 sidered as belonging to the disease entity which Addison had 

 described. He excluded, however, certain of Addison's origi- 

 nal cases as not belonging to this category. Wilks first noted 

 the enlarged lymph nodes and lymphoid tissue, and the hypo- 



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