On granular kidney and physiological albuminuria : being the Lettsomian lectures delivered before the Medical Society of London / by Samuel West.

  • West, Samuel Hatch, 1848-1920.
Date:
1900
Catalogue details

Licence: Public Domain Mark

Credit: On granular kidney and physiological albuminuria : being the Lettsomian lectures delivered before the Medical Society of London / by Samuel West. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    The patient continued in much the same condition for a time, and then the heart slowly recovered itself ; the oedema of the ankles disappeared, and the general strength increased. Still the ]3atient remained short of breath on exertion, and the albumen persisted in the urine, though varying a good deal in amount from time to time. In June, i.e., four months from what he considered the commencement of his symptoms, while away from home, he was seized with acute pain in the head, which was attended by some thickness of speech and delusions. These symptoms lasted a few days.and disappeared, but they returned, though in less degree, at intervals of a week or ten days. In these attacks, besides the acute pain in the head, there was a good deal of cloudiness of ideas, and he would do strange things, e.g., take his money out of his pockets and let it fall about the floor, without attempting to pick it up again. On June 20th he had an extremely severe attack of headache, which made him cry out with pain, and was accompanied with delusions, thickness of speech, and excitement. This attack also cleared up in a few days, but left him with a constant vertical headache, and pain also down the back of the neck. The albumen at this time had somewhat increased, but there was only slight oedema of the ankles. On August SOthhewas suddenly seized with right hemiplegia andaphasia, with delusions. He was apparently in a dying condition for some days, but slowly recovered. In 14 days the paralysis had passed away, and there was nothing left but some thickness of speech and cloudiness of ideas. A few days later he was attacked with acute mental excitement and delusions. He thought he was going to be killed, and had people coming after him to take him ; used to arrange cushions on the floor, and say they were corpses ; was constantly in a state of terror ; would catch hold of his wife and others, and say that he was saving them from some danger ; would pour his medicine, &c, on the floor, and so on. This attack subsided for a week or so and then returned, and continued more or less up to the time of his death, which occurred on October 6th, and was due to gradually-increasing exhaustion and cardiac failure. During the last six weeks of life the patient was in a condition practically of acute mania. This patient, again, thought himself well till but a few months (nine) before his death. The early symptoms, those of slight cardiac failure, rapidly improved under treatment, and were soon replaced by symptoms of another and much more serious kind. A succession of curious cerebral attacks followed of short duration, and attended with more or less psychical disturbance, and ended in an attack of right hemiplegia and aphasia. This, though grave enough to cause coma and threaten life for a few days, passed off completely in a fortnight. The last few weeks of life were passed in a condition of acute mania. The case is a good illustration of one of the most interesting and least recognised modes of termination of granular kidney.