Let US now consider those cases of lesions of the
supra-reual capsnles without melanoderma • and
which constitute a fourth of the whole number of
obsei'vations, associated togetlier under the name
of "Addison's disease." A careful examiuatiou of
them shows that in only four out of the fifty-eight
eases were the peculiar symptoms of Addison's
disease manifested: such as the marked asthenia,
the obstinate vomiting, and other nervous phenom-
ena. In one of these instances (ohs. 44), there
was absence of vomiting; and the asthenia was
produced by disease of the spleen, hemorrhage,
and phlebitis. Three cases remain for our con-
sideration.
In the first case (obs. 12), the asthenia was asso-
ciated with amemia, vomiting, and syncope; and the
sapi-a-rcnal capsules and pulmonary organs were
in a tubercular eomlition. The capsules were
augmented in volume, and contained nodules of a
pale yellow color, which were caseous and creta-
ceous in places. The duration of the disease was
only six weeks; and the patient was a man, aged
twenty-six years.
The second case (obs. 19) was that of a man,
aged forty-six years. The symptoms of this patient



HYPERTROPHIES.
