li's THE DUCTLESS GLANDS 



modern research will enable him to understand the clinical 

 phenomena of Addison's disease, and to treat his patients in a 

 scientific spirit. On the other hand, the physiologist is eager 

 to acquire whatever information can be derived from the realms 

 of clinical pathology and pathological anatomy, as to the func- 

 tions of the adrenal bodies. The fuller and more accurate is 

 our knowledge of diseased conditions of the organs, the sounder 

 will be our progress in both these conditions. Pathology has 

 taught us something of the adrenals, and physiology has 

 contributed certain facts of primary importance. It must, 

 however, be admitted that it is not possible at the present time 

 to combine the knowledge derived from these two sources in 

 such a way as to give an intelligent explanation of the functions 

 of the adrenal bodies, and at the same time to offer a satisfactory 

 explanation of the symptoms of Addison's disease. 



Addison's disease is characterized by the cardinal symptoms 

 of extreme muscular weakness, nausea and vomiting, and an 

 exaggeration of the normal pigmentation of the skin. 



Addison attempted to elucidate the nature of a malady 

 which he had styled " idiopathic anaemia," from an inability 

 to associate it with any exact pathological condition. He was 

 thus led to the discovery of the diseased state of the adrenal 

 bodies, and the association between this diseased state and the 

 train of symptoms which bears his name. The observations 

 were confirmed but not much extended by Wilks, Trousseau, 

 and Greenhow. It was Trousseau who first used the term 

 ' ' Addison' s disease . " It must be admitted that comparatively 

 little has been added to our knowledge of the clinical aspect of 

 the disease since it was first described. 



Addison considered that any lesion of the adrenal bodies 

 which would interfere sufficiently with their function would 

 give rise to the disease. Wilks and Greenhow were, however, 

 of a different opinion viz., that the true morbus Addisonii 

 has essential peculiarities of its own, that no other disease or 

 degeneration of the adrenal bodies is capable of producing the 

 same associated train of symptoms. The modern view is 

 entirely in accordance with that first expressed by Addison, 

 that the symptoms are due to an interruption of , or a deficiency 

 in, the functional activity of the adrenal bodi< -. 



secondarily comes into contact with this system. The chromaphil cells 

 appear first in close relation \\iih h- walls of (ii.iin 1. 1. ..,<!% 



