447

’Germany as a whole has really experienced no winter yet, asthe word is generally understood in that region. At Berlin

last month there were only three days with an afternoontemperature at the freezing-point or below it, and on many ofthe nights the sheltered thermometer remained some wayabove 32°. Falls of rain and snow were much more frequentin this country than in the south of Europe ; Nice and Palmawere fine and dry nearly throughout the month. There was,

nevertheless, more sunshine than usual in many parts of theUnited Kingdom. In London (Westminster), where an

average January gives no more than 19 hours, there were 35hours, while along the south cuast, where the weather was more than twice as sunny as in London, there was also a limarked excess on the average. I

* A day with at least 0-04 inch.

THE PATHOLOGY OF ADDISON’S DISEASE.

AT a meeting of the Pathological Section of the RoyalSociety of Medicine, held on Jan. 18th, Dr. Herbert S.

French described a case of extensive yet incomplete fibro-caseous disease of both suprarenal capsules in which

symptoms of Addison’s disease were not present.’ 1 In the

course of his remarks he stated that the interest of the

case lay mainly in the fact that it afforded to some extenta natural experiment upon how much less than the normalamount of suprarenal gland tissue a full-grown humanbeing might have without developing symptoms of

Addison’s disease. It must be here remembered that

cases have been recorded in which after death the supra-renals have been found to be extensively destroyedby tuberculosis or new growth, in which, nevertheless,definite clinical symptoms of Addison’s disease had been

.absent during life. Further, cases have occurred having1 THE LANCET, Feb. 5th, 1910, p. 368.

the clinical characteristics of the disease in which caseationof comparatively small amount was found in the suprarenalsafter death, perhaps only in one; and, lastly, there havebeen cases indistinguishable from Addison’s disease in whichthe suprarenal capsules themselves were healthy, although thesurrounding sympathetic nerve plexuses and semilunar

ganglia were implicated in dense adhesions or in a growth,such as lymphadenoma. In other words, although tuber-culous lesions of the suprarenal bodies may give rise to theclinical phenomena of Addison’s disease, the exact patho-logy of that condition is not known. Whether Addison’sdisease is due to an inadequate supply of adrenalin or whetherit is an auto-intoxication due to inadequate excretory or anti-toxic activity of the suprarenal bodies has been fully argued.The whole subject has been ably considered by Dr. H. D.Rolleston in Allbutt and Rolleston’s System of Medicine"

"

(Vol. IV., Part 1, p. 395), where the author gives an

excellent summary of the present knowledge of the subject.He is of opinion that Addison’s disease is due to inadequacyof the chromaffin or adrenalin-secreting cells, which are

chiefly situated in the medulla of the gland but are also

found in connexion with the sympathetic trunks. He alsobelieves that it is possible that there is a second factor at

work-namely, irritation of the sympathetic nerves, whichmight be due to adhesions and invasion of the pericapsularnerves or ganglia or toxsemic in nature, due either to failureof a hypothetical antitoxic function of the cortex of the

adrenals, or to disturbed metabolism resulting from absenceof adrenalin. Dr. French’s interesting case is one more

proof that we have much to learn about Addison’s disease.

MOROCCAN SAINTS.

THE Marabouts or Mussulman saints of Morocco seem

possessed of many of the attributes of savage medicine men.It is curious indeed to find the Moors, who in Spain becamethe fathers of medieval medicine, so retrograde in their

original habitat in Northern Africa. The Marabouts, ofwhom an interesting account has lately been published byProfessor Montet of Geneva, are supposed by their super-stitious admirers and disciples to possess any number ofmiraculous powers. Their saintliness, which is often of themost lax and questionable order, confers upon them the

power of becoming invisible, shot-proof, ubiquitous, or

gaseous and luminous. After death miracles, especiallythose of healing, are worked at their tombs. Theirrelics perform cures and resurrect the dead, and

the faithful, with a fervour peculiarly oriental, flock

to their shrines to pray for health. Barren women and

impotent men are especially devoted to this cult. The old or

impotent men, presumably with large harems, address theirprayers, we are told, to the relics of the holy Mogdoul ofMogador, who, according to Professor Montet, is a deifiedScottish highlander, one Macdonald, who came as a renegadeto Morocco as lately as 1760. Many of the Marabouts aredoubtless epileptics. One such, notorious for his assaults onwomen, which were reverently screened by his admirers, isdescribed at some length by the Genevan traveller, whoquotes from the works of L. S. Chenier, a consul, author of"Recherches Historiques sur les Maures" (1787). Thissaint prefaced his outrages with convulsive movements.Often idiotic or epileptic themselves, these so-calledsaints are held to be sovran exorcisers of evil spiritsor djinn (pl.). Near the tomb of Sidi Jacoub at Tlemcen

there is a niche or small shrine called locally Bit-Djenoun,the House of the Djinn. The guardian of this shrine

informed Professor Montet that the evil spirits repairedthither, and that "the possessed," whom science regards asthe epileptic, are wont to resort to the same place in order tobe cured. The man possessed passes the night there, taking