THE ADKENAL GLANDS 75 



sist of a soft, cheesy material. Several areas typi- 

 cal of a tuberculosis lesion were found. 



The "pigmentation" is usually a characteristic 

 feature of the disease. Sometimes it is absent, and 

 sometimes it is present in diseases other than Addi- 

 son's. Where it is present the color may vary any- 

 where from the dark hue of the Negro to a faint 

 sunburn brown. Characteristic also of Addison's 

 disease are the signs of muscular weakness (with 

 no corresponding emaciation). "The patient is 

 very easily tired, and is never able to get properly 

 rested." One may add that in most cases the blood 

 pressure is very low, the heart feeble in action, the 

 temperature is usually subnormal, and the patient 

 presents an anemic appearance. 



The marked pigmentation of the skin in Addi- 

 son's disease is supposed to be due to a disturbed 

 relationship between adrenaline and melanin, the 

 characteristic pigment present in the skin. When 

 the adrenals are diseased and the amount of adrena- 

 line reduced as a consequence, the factor that con- 

 trols melanin formation is removed, and an excess 

 of the skin pigment is deposited. 



The reader will notice analogies between this 

 theory and the one advocated by Cassan more than 

 a hundred years ago. 



Effect of adrenal extract. We have seen that 

 cases of hypothyroidism, such as myxedema, can 



