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on the already discoloured skin. Although the discoloration is generally most marked on certain parts of the body, and may even exist on some parts while the skin of other parts is of the normal hue, there is rarely, or never, any definite line of demarcation between the discoloured and normal portions of the skin; but the former fade insensibly into the latter. The characteristic discoloration is not restricted to the skin, but, in well-marked cases, is usually found upon the lips in the form of an irregular stain running lengthwise, and upon the gums and buccal mucous membrane in the form of stains or patches; these last may, perhaps, when present, be considered as the most decisive of the external diagnostic signs of Addison’s disease. It is, on the other hand, important to remark that the conjunctivæ always remain uncoloured, and in the more deeply coloured cases their pearly whiteness presents a striking contrast to the dusky hue of the face. I may mention, by the way, that this discoloration of the gums and buccal mucous membrane affords another analogy between the discoloration of Addison’s disease and the natural colour of the darker races; two Hindoos who were hospital out-patients of mine having presented dark stains on those parts, exactly resembling the stains found in cases of Addison’s disease. Moreover, in one of them I noticed that some superficial cicatrices were of a darker shade than the surrounding integument.*
We have had in the hospital, during the last year, two well-marked
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* While these sheets are passing through the press, I have
received, from
A mulatto, aged 43, the child of an escaped negro slave by
an English mother, about six years ago began to change colour;
his wife first noticed white specks on his back, which gradually
coalesced and spread until the whole trunk became white,
though less so towards the hands and feet which remained dark.
The white colour terminated half-way up the neck and the face
remained dark, with ordinary mulatto features and dark, crispy hair;
spots of white are appearing, however, on the right side of the
forehead and at the angles of the jaw. The white skin is soft
and healthy, not to be distinguished from that of a European.
The man had good health up to three or four years back,
but has since been ailing, apparently in consequence of
intemperate habits. He suffers from bronchitis, and on each
occasion that a blister has been applied to the surface,
it has sufficed to reproduce, in the white skin, several
irregular spots of the original dark colour, which have hitherto