Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

101/440 (page 85)

o£ inflammation. That tlie albuminous excretion in tlie first two cases was visible in tbe capsules, and not merely in tlie uriniferous tubules, is a proof that phosphorus, as we might •a pi-iori expect, acts injuriously, not merely upon the epithe- lium of the uriniferous tubules, but upon that of the glome- rular tufts as well, and possibly upon tbese vessels them- selves. The last supposition is borne out by the fact that effusions of blood appeared in the capsules. No fatty degeneration within these parts could be detected under the microscope, because the poisonous doses of phosphorus were very small, but in one case of poisoning by this agent in a girl, I noticed that the glomerular vessels were in a state of profound fatty degeneration. The clinical observations of cases of phospborus-poisoning are in complete accordance with the experimental results, and it therefore appears extraordinary that the absence of albuminuria should be described as a normal occurrence in poisoning of this kind. The truth, is that albuminuria is the rule, and its absence the exception in such cases. In 1864, at a time, therefore, when phosphorus-poisoning first began to attract general attention, Meischner found albumi- nuria seven times in a collection of ten cases, and in a recent treatise Hessler tells us that be found this symptom twelve times in fifteen cases (73). We are justified in sup- posing that in the cases in which it was absent, its non- detection was possibly due to the fact that only tbe usual test, viz. boiling, was tried, and the more so, since in phosphorus- poisoning, as I have already mentioned, peptone-like bodies appear in the urine (see pp. 8 and 81). It almost appears as if the albuminuria in these cases had been disregarded for the sake of certain theories, or, possibly, the cause of the disre- gard may be found in the fact that the quantity of albumen -was so insignificant. But to my mind this is a proof that the fatty degeneration of the epithelium, and especially that of the uriniferous tubules, as the anatomical examination shows, is the real cause of the albuminuria; and that this is not due to other complications, such as acute inflammatory processes, for as a result of these latter, the urine always contains a very considerable quantity of albumen. On the other hand, in mere fatty degeneration of the epithelium, it