ON THE CAUSE OF PROLONGED EXPIRATORY MURMUR, AND ITS VALUE AS A SYMPTOM IN THE EARLY DIAGNOSIS OF TUBERCLE IN THE LUNG

seend ft in his e tu: d I canwl io tha in this ease there disa of the oules. He ha the pearanoe of a br pEa dis comp io bronzed skin being inodifd somewhatas jaundico is modified which supernemas upon diseae of the pancreas, a se in drawings of judLe in panreatic diseae A cae has en reported by Mr. George May in the number of the ASOCIATION MIcLu Jouaim for Septembe 20th, under the head, "Brown Colour of Skin, with Normal State of the Suprareal Capsules," in the Annual Report of the Reading Pathological Society, which confirms the view I have taken of the cae; namely, that mhere are many brown skns without disee of the suprarenal capsules; yet I fully agree with Dr. Addison in believing that disease of the whole or part of the suprarenal capsules will cause a corresponding tint in the colour of the skin; and a sliht amount of disease may take place in these bodies witiout much effect upon the skin. I think that the difficulty of diagnosis in these cases will be readily overcome if we attend to the history of these cases. In looking over the full history of those cases which I have seen, I find that the patients have suffered from much mental anxiety, and that the first appearance of discoloration of the skin has been observed to come on afterwards; then come on the obstinate and prolonged gastric symptoms; and, from examinations that have been made of the mucous membranes after death, it is quite evident that they participate in the diseae to an equal amount at least as the skin. (See Dr. Hodgkin's account of the mucous membranes in Dr. Bright's case, reported by Addison, and other cases.)