The relations of cardiac hypertrophy to renal disease / by Robert Saundby.

  • Saundby, Robert, 1849-1918.
Date:
[1880]
Catalogue details

Licence: Public Domain Mark

Credit: The relations of cardiac hypertrophy to renal disease / by Robert Saundby. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    the other forms of Bright's disease, hypertrophy, though common, is certainly less frequent. Bright,* in recording the various organic changes in lOO cases of renal disease, says, The obvious structural changes in the heart have consisted chiefly of hyper- trophy, with or without valvular disease; and what is most striking, out of fifty-two cases of hypertrophy, no valvular disease whatsoever could be detected in thirty- four ; but in eleven of these thirty-four, more or less disease existed in the coats of the aorta; still, however, leaving twenty-two without any probable organic cause for the marked hypertrophy generally affecting the left ventricle. This naturally leads us to look for some less local cause for the unusual efforts to which the heart has been impelled ; and the two most ready solutions appear to be, either that the altered quality of the blood affords irregular and unwonted stimulus to the organ immediately, or, that it so affects the minute and capillary circulation as to render greater action necessary to force the blood through the distant sub-divisions of the vascular system. In the next paragraph, he says, It is observable that the hypertrophy of the heart seems, in some degree, to have kept pace with the advance of disease in the kidneys ; for in the majority of cases where the muscular power of the heart was increased, the hardness and contraction of the kidney bespoke the probability of a long continuance of the disease. In this table Bright had included not only granular kidney, but all forms of renal disease with albuminuria. It will be found that the pendulum of modern opinion is now again oscillating between these two explanations in spite of forty years of discussion and observation with * Cases of Renal Disease accompanied with Albuminous Urine. Guy's Hospital Reports, vol. i., p. 397.