On the pathology and treatment of albuminuria / by William H. Dickinson.

Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: On the pathology and treatment of albuminuria / by William H. Dickinson. 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.

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    For the last two years he had been extremely intemperate, drinking beer, gin, and mm. Six weeks before he came in, being at that time in apparent health, he was attacked with pain in the legs, particularly in the calves, immediately followed by an outbreak of red spots, which were described as resembling purpura. On the next day but one he began to have sharp pain in the loins; and the urine, which had previously always been clear and plentifid, became very dark in colour. Four days later his face became swollen, and the dropsy gradimlly spread over the Avhole body, occupying eight or nine days in the process. The pain in the loins now subsided, as he supposed, in consequence of his having been cupped in that situation. For four or five months before his attack he had been very subject to catarrhal attacks in consequence of exposure to cold, but there had been no definite exposure to which the disease could be attributed. When he came under observation his face was white and bloated. The whole body, more particularly the legs and scrotum, was highly adematous. He lay propped up in bed with the right side lower than the lefl, and it was evident on auscultation that the right pleura contained fluid. There was evidence of fluid also in the peritoneum. There was no pain in the loins, but there was tender- ness, especially over the right kidney. The appetite was good and the bowels regular, but he sometimes vomited. The tongue was clean. The pulse weak, 84. The urine was diminished in quantity and loaded Avith albu- men, the coagulum occupying three-quarters of the tube. It was not coloured with blood, though blood corpuscles were seen under the microscope. There was also a considerable deposit of renal epithelium, some of which was fatty, while some closely resembled pus. Many transparent casts were found, some of which imbedded epithelial cells, and others specks of oil. The frequent use of compound jalap powder, of]diuretic medi- cines, including digitalis, and of blue pill to the extent of salivation, failed to relieve the dropsy. He was irequently cupped upon the loins with apparent benefit. On December 9 the scrotum was punctured, and much fluid evacuated. Shortly afi;er this it was found necessary to repeat the same expedient upon the legs. The operation was entrusted to a house surgeon, who by way of experiment pricked the] left leg Avith a needle, asing a lancet \vpon the right. Fluid escaped in large quantity. The openings which had been made with the needle
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