Kidney diseases / by W.P. Herringham ; with chapters on renal diseases in pregnancy by Herbert Williamson.

  • Herringham, W. P. (Wilmot Parker), Sir, 1855-1936.
Date:
1912
Catalogue details

Licence: In copyright

Credit: Kidney diseases / by W.P. Herringham ; with chapters on renal diseases in pregnancy by Herbert Williamson. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    patient was on another occasion given 5 grains of phenacetin. The phenol reaction appeared two days later. The method of experimenting with common salt is to put the patient on a pure milk diet for five days and on the third day to give 10 to 20 grammes of common salt in water, or after calculating the amount of salt in a fixed diet to add on one of a series of days 10 grammes of salt, and to estimate the output on each day of the series. The amount excreted, and the rapidity with which it passes, furnishes a measure of the permeabiUty of the kidney. As a test of the glandular activity phloridzin has been much employed. It is said that renal disease greatly diminishes or retards the production of sugar. It must, however, be confessed that these methods of testing the action of the kidney are subject to the drawback that the kidney does not react aHke for all substances. The methylene blue reaction may not vary with the chloride test, and either or both may react differently to urea. Thus it is not safe to argue that a good reaction with any one of them means a good excretion of the natural pro- ducts. Yet this is, after all, the point at which the whole process aims. We owe, however, to Schlayer * an interestiag development of this line of research. From experiments on rabbits he believes that the powers of excreting water and salts vary independently. He thinks that this function test {FunJctions- priifung) is of equal importance with, or even more important than, anatomical investigation, and founds on it a distinction between ' vascular' and ' tubular' nephritis. It is too early yet to say that the theory has been established. His method has been used clinically by v. Monakow.^ At present, however, there is nothing better or more reliable, probably it would be safe to say that there is nothing so reliable, as an ordinary chemical analysis of the excretion carried out with the precautions mentioned above. For ordinary medical purposes the excretion of both kidneys together is all that is necessary for examination. A nephritis confined to one side is practically never seen.