ADDISON'S DISEASE. 49 



the body as from a fall from a great height. In other cases there is 

 no other anomaly, nor is there any apparent cause for the mobility 

 of the viscus. When the patient stands erect, the movable kidney 

 may be felt usually below the liver, or even still deeper. Its char- 

 acteristic bean shape is distinctly recognizable, and it often can be 

 pushed a considerable distance to the right or left, but more easily 

 upward and downward. A patient in my ward, by moving and 

 shaking his body, was able to get his kidney into a great variety of 

 positions. There are either no evil results whatever attending the 

 affection, or they depend upon complications, although colics and 

 slight inflammations of the peritonaeum may result from pressure of 

 the movable organ upon the other viscera. The knowledge that 

 she has a tumor in her abdomen often acts very injuriously upon 

 the spirits of the patient, who sometimes becomes hypochondriac. 

 Little can be done by way of treatment for a movable kidney ; but 

 the patient (particularly if she have very flabby abdominal walls) 

 generally feels better when she wears an elastic bandage of gum 

 elastic or knit cotton. 



CHAPTER XIII. 

 ADDISON'S DISEASE BKONZED SKIN. 



[THIS disease, first described by Addison, still presents an obscure 

 problem, notwithstanding the laborious researches of many of our 

 most acute observers ( Virchow, Meissner, Averbeck, Klebs, Eulen- 

 burg, Guttmann, Risel, and others). All former doubts as to the 

 real existence of such an independent affection are now dissipated ; 

 but it has been shown that the lesions which used to be thought 

 fundamental and characteristic of it, namely, the morbid state of 

 the suprarenal capsules and the dark stain upon the skin, though 

 commonly present, are not its essential features. The original as- 

 sumption that Addison's disease depends upon a degeneration and 

 destruction of the suprarenal capsules is contradicted by the nega- 

 tive results of experiments made in seeking out the hitherto un- 

 discovered functions of these organs, as well as by the fact that the 

 capsules have been found destroyed or in a state of disease in bodies 

 of persons who during life presented none of the symptoms of the 

 malady. Attention was thus directed to the sympathetic plexus of 

 nerves adjacent to the capsules, the implication of which in this 

 affection Addison himself had already pointed out ; and the opinion 

 was gradually reached by a number of English, French, and German 

 observers that a morbid state of the abdominal sympathetic, par- 



