On the waxy or amyloid degeneration of the kidney : a communication read before the Medico-Chirurgical Society of Edinburgh / by T. Grainger Stewart.

  • Thomas Grainger Stewart
Date:
1861
Catalogue details

Licence: Public Domain Mark

Credit: On the waxy or amyloid degeneration of the kidney : a communication read before the Medico-Chirurgical Society of Edinburgh / by T. Grainger Stewart. Source: Wellcome Collection.

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    any rigor, headache, or other acute symptom. On account of the swelling, she sought admission to the Infirmary. On admission, there was great capillary development over each malar bone, the eyes were suffused, the legs and thighs oedema- tous, and the abdomen slightly distended. There was dulness on percussion at the base of both lungs posteriorly, with feebleness of respiration and increased vocal resonance; considerable bronchial rattles on both sides. She had a frequent hard cough. Appetite good, tongue slightly furred, thirst great. Liver and spleen not enlarged, so far as could be made out in the state of the abdomen. Bowels constipated. Catamenia appeared last week, for the first time since August. Urine distinctly albuminous, ranging in amount from 74 to 130 oz. per diem ; sp. gr. 1005, containing some hyaline and faintly granular tubecasts. Cardiac sounds were healthy, but feeble; pulse feeble. She was put upon general stimulant and tonic treatment, with good diet, but became steadily worse. On the 27th of May she was attacked with diarrhoea ; and the amount of urine diminished from about 70 or 80 oz. to 30 or 40, and even less, al¬ though, from the state of the bowels, it was often impossible to esti¬ mate it. The diarrhoea could not be got to yield, and weakness constantly increased till the 10th of June, when she died. For the last two or three days of her life she was drowsy, and passed her urine and faeces involuntarily in bed, but could always be roused to answer questions. She had no tendency to convulsions. On post-mortem examination, the lungs were almost healthy ; heart had a small fibrous mass on the cardiac surface of one of the aortic valves. In the middle of the abdomen the parts were found matted together by a cancerous mass, and in the uterus there was a slight cancerous deposit. The liver, spleen, and kidneys were all distinctly waxy. All the lymphatic glands of the abdomen were enlarged. The left supra-renal capsule was filled with cancerous fluid. In this case it will be observed that I have not dwelt upon the diagnoses, which were made during life, of the cancerous lesion of the abdomen, and of the deposit on the aortic valve, because these were not essential to the case in the light in which we have to con¬ sider it. Still it is important to bear the complication with cancer in mind, as it may be found that it also predisposes to the amyloid degeneration. ! shall now relate two cases in which the symptoms were quite chronic, and which have not as yet proved fatal. Case III.—Edward Burns, a labourer, set. 30, married, resident in Edinburgh, admitted to Patou’s Ward, January 12, 1860. Patient states that lie has had very little sickness, and, in particular, never had syphilis ; but he confesses to have suffered from bubos, resulting from a strain; and his prepuce is remarkably contracted, and his throat presents most syphilitic-looking ulcerations. On admission, his throat was ulcerated, his voice was husky, and
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