CHAPTER V. 

 SYNDROMES OF ADRENAL INSUFFICIENCY. 



Our conception of adrenal insufficiency only goes back 

 to 1855. Addison at this time described a disease, which 

 has since been given his name, characterized by a pro- 

 gressive asthenia, and accompanied by circulatory 

 disturbances, pains and pigmentations of the skin, giving 

 it a particularly bronzed appearance. He believed that 

 this bronzed affection was due to some alteration of 

 the adrenals. 



Soon after a number of observers published cases in 

 which lesions of the adrenals had occurred without any 

 pigmentation. Dieulafoy and his pupil Bressy have 

 published under the name of "abortive forms of Addison's 

 disease" clinical observations characterized by the signs 

 of Addison's disease without pigmentation. 



Sergent and Bernard, following the investigations of 

 Brown-Sequard, cpntinued by Abelous and Langlois, 

 showed that the disease described by Addison was in 

 reality a complex syndrome in which two types of symp- 

 toms could be made out; those resulting from an adrenal 

 insufficiency (among which asthenia and circulatory 

 disturbances) and symptoms resulting from an irritation 

 of the sympathico suprarenal nervous system, among 

 which pigmentation was the most characteristic. 



They described adrenal insufficiency as : the expression 

 of the decrease or the suppression of adrenal functions and 

 separated it from the syndrome of Addison, characterized 

 by pigmentation. They considered the "bronzed disease" 

 described by Addison as an association of the syndrome of 

 adrenal insufficiency with that of a sympathetic affection. 



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