Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

112/440 (page 96)

under the name Briglit's disease/' There is no doubt that a cause for the symptom in question is to be found in a renal lesion. This latter certainly may (and this view is highly prob- able) often originate in a morbid condition of the blood, which may therefore be fairly described as the indirect cause of the albuminuria in these cases. It may be diflBcult to explain the occurrence of albuminuria in those much rarer cases in which no lesion of the kidney exists. For it is beyond doubt that there are such cases, and that albuminuria is not always symptomatic of a nephritis or of some other demonstrable kidney-lesion. I need only refer to the detailed description already given (see page 15, et seq.) of albuminuria as occurring in perfectly healthy men, or to the albuminuria in patients who show no other indica- tion of kidney-disease, and in whom when death occurs from some other cause, the most careful examination fails to detect any abnormality in the kidney, any trace of degeneration of the epithelium, any swelling and cloudiness of the parenchyma, appearances which are yet regarded by many indeed as devoid of significance with regard to albuminuria. We have become acquainted with the existence of circumstances which, in certain conditions of the circulation, may give to albuminuria in the absence of any disorder of tissue in the renal paren- chyma ; but not in all cases of this nature can the circulatory changes be positively demonstrated or even assumed as prob- able, without straining the interpretation of the symptoms. It appears to me that for such cases, probability must be admitted for the theory that the albuminuria is due to changes in the composition of the blood. I say designedly changes in the composition of the blood, and not changes in the albuminous substances in the blood as is usually expressed by those who make use of the term hasmatogenous albumin- uria. Not that I consider an abnormal condition of the albu- minous substances as impossible ; on the contrary, I regard it as not only possible but even not improbable, so far as many cases are concerned, and I will soon give my reason for so doing; but I think it is at least as probable that other changes in the composition of the blood, havmg no connection with any abnormal condition of the albumen, may induce albuminuria, and I am alluding not to hypothetical