221 Philada. Med. Times, 1885, No. 452.
The occasional occurrence of pigmentation of the skin in abdominal tuberculosis, retro-peritoneal tumors, cancer of pancreas, and in uterine irritation lends support to this view.
The weak points of this view are—the doubtful nature of the changes in the ganglia and the nerves in many cases. Mere increase of the normal pigment, slight fatty degeneration or swelling, so often recorded, should not be regarded as important, for they occur under a variety of conditions. Of positive swelling and redness of the ganglia, fibroid atrophy with destruction of nerve-cells and degeneration of the nerve-fibres, there can be no doubt, but about less marked alterations opinions will differ whether they are truly morbid or not. The fact that in certain well-observed cases the ganglia and nerves were found normal is hard to reconcile with a theory that the disease is an affection of the abdominal sympathetic. Burger states222 that there are nine cases in which changes could not be found, and there are the recent cases of Huber,223 Hebb,224 Foa,225 and Hadden.226
222 Loc. cit.
223 Virchow's Archiv, Bd. lxxxviii.
224 Lancet, 1883.
225 Virchow-Hirsch, 1879.
226 Brit. Med. Journ., 1885, i.
Hale White's recent observations,227 as well as those of Saundby,228 on the histological changes in the sympathetic clearly show that many of the changes which have been described in cases of Addison's disease are common in other affections, and have probably no direct association with the characteristic symptoms of the malady.
227 Ibid.