Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

104/440 (page 88)

one with regard to the epithelium of the uriniferous tubules. We ascribe to these cells, and to these alone, the power and the task of preventing the albumen of the blood in the inter- stitial vessels, and of the lymph, from escaping into the uri- niferous tubules, and we must therefore infer that when their degeneration, fatty or otherwise, has reached a certain degree, the fulfilment of their task will become impossible. Cer- tainly, it is said, when they are in a state of fatty degenera- tion, but not in that of fatty infiltration ! It would scarcely be necessary to advert to the difference between these two con- ditions, were it not for the fact that the physiological occur- rence of epithelial cells, containing fat, in the kidneys of several animals, e.g. dogs and cats, has been referred to as evidence of the insignificance of fatty changes (76). But in these instances the condition is that of fatty infiltration, and no demonstration is requisite to show that the absorption of ^ fat by otherwise healthy cells is one thing and the conversion of the substance of the cell into fat is quite another thing, and that the fatty changes in the two cases are of entirely different import as regards the function of the cell. It may be remarked that a physiological albuminuria often enough occurs in dogs and cats; this, however, has nothing whatever to do with any fatty contents of the renal epithe- lium, but is dependent upon other causes (see note, p. 20). Fatty degeneration of the renal epithelium occurs in animals after long-continued exposure to excessive heat. The urine, however, becomes albuminous very soon after the heat is applied, long before any fatty degeneration can be demon- strated, and, as before shown, this result is due to other causes (see p. 47). When, however, in the further course of such exposure, albumen occurs in the urine—a fact of which there can scarcely be any doubt, though I have no knowledge of this subject—a share at least in its causation must be attributed to the degeneration of the epithelium, and the more so since that cause to which the appearance of albuminuria at the commencement of the exposure to heat must be ascribed, viz. the increased blood-pressure, ceases to operate with the continuance of the abnormally high temperature and of its deleterious effects upon the muscular tissue of the heart.