The morbid effects of the retention in the blood of the elements of the urinary secretion / by William Wallace Morland.
- Date:
- 1861
Licence: Public Domain Mark
Credit: The morbid effects of the retention in the blood of the elements of the urinary secretion / by William Wallace Morland. 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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![Lungs. These organs are constantly found in an oedematous condition, and sometimes emphysematous. Dr. Braun, recording the fact that em- physema was long since observed by Boer, says that it is now considered “as always the secondary result of the fits”—i. e., uraemic convulsions. Op. cit., p. 62. Heart.—This organ is reported to be usually “empty and flaccid.” {Braun.) We may thence infer feebleness of circulation, and impairment of its own tonicity, and of that of the bloodvessels, by reason of the im- poverished state of the blood, their natural stimulant. Kidneys.—Generally, and according to some authors, always, the kid- neys exhibit more or less extensive and advanced signs of Bright’s disease. In cases where the retention of urea in the blood has been caused by some other agency—such as obstruction, etc., there would naturally be traces of congestion, and perhaps of inflammation, although not uniformly; a nearly natural state might well enough exist. As we previously intimated, it does not seem necessary to give, in this place, an elaborate account of the changes wrought by granular and fatty degeneration of the kidney, in connection with uraemia; and for reasons already stated. Moreover, these general appearances are well known, and abundantly set forth in many treatises. Those who would see, however, an admirable and somewhat condensed account of the changes of this nature effected in the renal tissue in urinaemic cases connected with pregnancy {eclampsia puerperalis, seu gravidarum), should consult the chapter of Dr. Braun’s work, to which we have so frequently referred. A few extracts only will be made by us, and those chiefly to call attention to certain pro- minent points in the renal necroscopic phenomena. Dr. Braun bases his descriptions on the three forms of Bright’s disease proposed by Frerichs. In the first stage, that of hyperaemia and commencing exudation, the surface of the kidney is smooth, the capsule is easily removed, the plexus of veins on the surface of the kidneys is dilated, and full of dark blood.” {Loc. cit., p. 62.) “ The pyramidal masses [renal papillae] are likewise hyperaemic, and their injection is striped. The mucous membrane of the pelves and infun- dibula is swollen, and covered with vascular arborescence; and they contain a bloody fluid. Apart from hyperaemia, the finer structures of the kidneys do not appear to be essentially injured. Hemorrhagic effusions are very frequently observed, which sometimes take their rise from the glomeruli • sometimes from the vascular plexus of the tubuli uriniferi, sometimes from the veins on the surface of the cortical substance.” (p. 63.) In the first stage, the epithelial lining of the uriniferous tubes is stated not to be essen- tially altered; the tubes themselves are often filled with exuded blood— “ fibrin-cylinders.” In the second, or exudative stage, fatty degeneration commences and pro-](https://iiif.wellcomecollection.org/image/b21940198_0029.jp2/full/800%2C/0/default.jpg)
