Addison's disease in a boy, with calcification of the adrenals : with remarks / by H.D. Rolleston and E.J. Boyd.

  • Rolleston, Humphry Davy, 1862-1944.
Date:
[1914]
Catalogue details

Licence: In copyright

Credit: Addison's disease in a boy, with calcification of the adrenals : with remarks / by H.D. Rolleston and E.J. Boyd. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    The treatment consisted in rest in bed and adrenalin chloride solution (1 in 1000), ten minims in water three or four times daily by the month. Later sandwiches containing raw adrenal glands were given. After this the pigmentation appeared to increase. Remarks by Dr. H. D. Rolleston. Addison’s disease is rare in children. In 1897 Dezirot (4) collected 48 cases in children under sixteen years of age, and in 1910 Chemin (3) collected 56 cases under that age, but amongst these he includes the case of a girl, aged 3 years, which was published independently by Pitman (12), J. Ogle (11) and W. II. Dickinson (5), and was probably the earliest example of precocious sexual develop- ment associated with a cortical hypernephroma. Out of 55 of Chemin’s cases 6 only occurred in the first decade, and J. Thomson (15) states that Addison’s disease in children occurs almost exclu- sively over the age of twelve years. A most remarkable exception to this is the family with five cases of Addison’s disease at the same time—in the mother, and four children aged 7, 4,* 3^,* 2| years— recorded in 1900 from Edinburgh by Fleming and Miller (6). These patients when reported were all living, and the authors were obviously conscious of their exceptional nature, for they remarked that it maybe questioned if these five individuals are all the subjects of true Addison’s disease. It is noteworthy (a) that in “ an account of the epidemic outbreak of arsenical poisoning in the north of England and in the Midland counties in 1900,” E. S. Reynolds (13) mentions that some of the pigmented cases were diagnosed by his assistants as Addison’s disease, though in describing the extent of the epidemic he does not mention Edinburgh or any town so far north; and (b) that Fleming and Miller’s cases were published before the existence of this epidemic was recognised. Although there is no justification for considering Fleming and Miller’s cases to be examples of arsenical pigmentation, the exceptional nature of the cases and the coincidence of the epidemic in another part of the country are certainly sug- gestive. * These ages may remind the reader of the lines in James and Horatio Smith sja ‘ Rejected Addresses ’ and their own footnote : “ My brother Jack was nine in Mayf And I was eight on New Year’s Day.” 1 “ f Jack and Nancy, as was afterwards remarked to the authors, are here made come into the world at periods not sufficiently remote. The writers were bachelors.”