Who first described ADDISON’S DISEASE ?

Jan. 23, 2010 - PRLog -- It may occur after severe infection, massive adrenal bleeding, amyloidosis or surgical removal of the adrenal glands. Mostly the cause is unknown.

Thomas Addison (1793-1860) English Physician

Thomas Addison was born in Long Beaton, near Newcastle in 1793, the same year that Marie Antoinette was found guilty of treason and was beheaded on the guillotine. He chose a remarkably similar career path to Hodgkins (Hodgkin’s Disease) and Bright (Bright’s Disease), graduating from Edinburgh University (1815), and then moving back to London to pursue a medical career at Guy’s Hospital for the Incurables (1820). This hospital was founded in 1726, mainly as an overflow hospital for the neighbouring St Thomas's, which was working beyond its capacity. It maintained an emphasis on materia medica and medical treatment rather than on surgery, which remained the St Thomas's speciality. Addison was appointed assistant physician to the hospital in 1824, and lecturer in charge of materia medica three years later. It was 1827, the same year that Ludwig Beethoven died in Vienna following complications of pneumonia and dropsy.

Of passing interest is the fact that Addison like Beethoven, suffered from severe depression, developed deafness and was a brilliant teacher. But the similarity ends there. In 1802, Beethoven wrote the famous "Heiligenstädter Testament" to his two brothers, in which he confessed his misery and his wish to commit suicide. He of course recovered, but Addison’s depression deteriorated and it is less known that he eventually committed suicide by jumping out of an upstairs window and fracturing his skull. Addison remained shy and introspective and consequently built up a poor practice. He pioneered worked on the adrenal glands and in 1849, noted that tuberculosis was found at autopsy in 70 to 90 percent of cases of adrenal insufficiency. In 1855, he published a controversial paper on ‘the constitutional and local effects of the suprarenal capsule’, to which many Scottish physicians, particularly Bennett disagreed with the findings. It was largely because of Trousseau (Trousseau’s Sign) that the paper was eventually validated and this physician is remembered for calling the disease of adrenal insufficiency after Thomas Addison. He is also accredited for giving medical eponyms to both Graves and Hodgkin’s disease. Addison worked with many famous physicians during his period in Guy’s, including William Gull (Gull’s disease), with whom he first described the condition xanthoma diabeticorum. We remember Gull for describing the condition of hypothyroidism and for unsuccessfully treating Prince Albert after he contracted typhoid in 1861.Queen Victoria never recovered from her grief after his death and withdrew from social activities and dressed in black for many years thereafter. He also worked with Bright (Bright’s disease), with whom he tried to publish a medical text and is remembered for having contributed to most of the work on the volume.

He was the first doctor to describe circumscribed scleroderma, which is still known as Addison’s keloid in some parts of the world. He was also the first doctor to show that pneumonia occurred in the alveolar tissue and not in the interstitial cells. He described the progressive dysfunction of the adrenal gland associated with changes in brain tissue. This condition was later researched by the Austrian neurologist Schilder who noted loss of the myelin sheath surrounding nerve cells in the brain and the condition became known as Adrenoleukodystrophy or Addison –Schilder Disease.

Addison jumped to his death in 1860, the same year that Senator William Gwin of California and William H. Russell, of Missouri businessman bought 400 fast horses, hired 80 riders, and established the Pony Express Service.

Who am I?

South African Physician who graduated from Edinburgh and served with the RAMC in Africa during the First World War. In 1937 he became Professor of Medicine in Cairo on the advice of Sir Alexander Fleming. He died in London in 1959 and is remembered for giving his name to an autosomal nephritis associated with nerve deafness.

A.C. Alport

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Dr. Patrick Treacy is Medical Director of Ailesbury Clinics Ltd. He is Chairman of the Irish Association of Cosmetic Doctors. He is a Medical Advisor to the website Consulting Rooms. He wrote a Medical History series in 1999 for the Irish Medical TImes