33
sickness persisting ; at the same time it was thought that the
countenance grew darker, and he died on the 25th.
Post-mortem examination.- None was allowed beyond the brain
and abdomen. Of the former there was considerable softening,
and a large amound of subarachnoid fluid. The kidneys were slightly
enlarged, mottled, and in some parts the cortical substance was
entirely degenerated into fat. A few tubercles were strewed on the
surface. Tubercles were also observed on the spleen and on the
peritoneum covering the termination of the ileum. Tubercular deposit
was also found in one of the supra-renal capsules.
Case 6.- Another specimen, placed in the museum by
Dr. Hodgkin, was from a patient of
Dr. Bright. The case is very briefly related in the
post-mortem records, and no allusion is made to any interest bestowed
upon it by Bright, or even that he witnessed the
examination. The specimen affords a well-marked example of the change
which occurs in Addisons disease, of which no
doubt it was a case, since there is no other morbid condition mentioned
in explanation of the patients death. It will be seen that it
occurred only a few months previous to the one first related (No. 4),
and in both of them the specimens were preserved, showing that due
attention was bestowed upon the morbid condition of these organs,
although no suspicion seemed to be excited as to its being the cause
of death, nor, indeed, as far as I am aware, was anything advanced
connecting the symptoms with these organs.
Mary C.___, æt. 38, admitted into Guys Hospital under
Dr. Bright, October 29th, 1828, and died on November 11th.
She complained of pain in the chest, had a cough, and was supposed to be
labouring under phthisis.
Post-mortem examination.- The lungs were found to contain tubercles ;
but the other organs were healthy, with the exception of the supra-renal
capsules, which were enlarged, and occupied by a yellow, adventitious
deposit, which in parts was softened down.
In the description there is not sufficient disease mentioned to account
for death apart from that discovered in the supra-renal capsules.
Case 7.- The following is as interesting a case as any in the series,
and to an unprejudiced mind must constitute, I think, a proof beyond
all shadow of doubt as to the truthfulness of Addisons
discovery, since it will be seen that it was one of the first which
was observed after the publication of the monograph, and what is
deserving of especial notice is that the disease was foretold by the
publication of the diagnosis long before it was verified by the death
of the patient.
VOL. VIII.
3
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