A medical handbook : for the use of practitioners and students / by R.S. Aitchison.

Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: A medical handbook : for the use of practitioners and students / by R.S. Aitchison. Source: Wellcome Collection.

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

    152/402 (page 134)
    The tube casts found in acute Bright's disease are epithelial and hyaline granular and blood casts, along with numerous free blood Srpusclel granules, and .iel>ns (see Figs. 21, 22, ^S)- Jhe q-nU y of urea excreted is much diminished, and so are the other solid Istiluents of the urine. The oedema of the -^les and eyeh^^ appears early, and it soon extends to the other P^^/ts of he bod ahd to the serous cavities if the disease advance. . The ten ion of th^^ Dulse increases with the onset of the dropsy. In the la er stages, L the amount of water in the urine increases, the acidity diminishes, and there is an increase in the quantity of the solid constituents excreted : but the quantity of urine voided is still below the normal, and of a low specific gravity. The tube casts are then seen to be fatty, as in the chronic form, while the dropsy is muc]? increased. There is loss of appetite, nausea and vomiting, ^nd often diarrhea and the patient soon becomes ana:mic and emaciated. 1 he vision may become impaired _ from simple anoemia, or it may be the result oi albuminuric rclinitis. , ^;fiori i,v tVif> The history and course of acute Bnght's disease are modified by the cause as in scarlatina, diphtheria, &c. Pregnancy can only be v'wed L an exciting cause, apt to produce congestion o the Mneys in patients already predisposed to Bnght's disease. In scarlatina the Someruli being more affected than the tubules, there is a grea er dimi- Sn in the quantity of urine passed, and there is n-re chance of suppression. In acute Bright's disease, ansmg spontaneously the S (if any) lasts only for a few days. Recovery from this onn s qui e common; but death may ensue m the course « a w^eek f om uraemia. The case generally progresses slowly, and U^e drops) appears gradually, unless the urine be very scanty and then dropsy Ty occur wdthin'a few days. Death may result later f™- -h-s^ don or by gastro-intestinal disturbance and ancemia In the ca^es wHch recover, it may be three months before the health is restored. The ehronie form of Bright's disease may follow the acS - to nfoie commonly it develops insidiously, the result o chronic alcoholism, syphilis, malaria, chronic suppuration 01 metal pSsoninr It may arise from any cause which depresses the ^atahty Ke ttssues in^hose predisposed, constitutionally, to Bright s rh.™Irfi7.S;l5/re'p™.l>.=.s of ep,,,,..,.,. cc.„ and characteristic earthy cooui. body. The face now appears, and quickly spreads over the ^^holc Doc.).