Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

116/440 (page 100)

ponding increase in the secretion o£ urine and urea, as, for example, in diabetes, no accumulation can be supposed to occur. An accumulation of urea in the blood has been clearly demonstrated in disease of the kidney itself, simply as a result of impeded excretion, and always associated with diminution of the quantity of urine. There is, therefore, in all these cases in which the albumen or the urea, and possibly also the salts, are increased in quan- tity, a certain factor present, endued with the power of causing a much increased transudation of albumen, and con- sequently albuminuria. Bnt it is by no means a single factor, for a number of more or less active influences, capable of producing the same effect, come into play in the above- mentioned instances. Thus in phosphorus-poisoning, there is the degeneration of the epithelium, and the diminution in the quantity of urine consequent upon diminished arterial pressure; this latter is also present in cases of profuse watery evacuations, in cholera, violent diarrhoeas, &c., while in fever, of which we shall presently speak particularly, many other factors co-operate, by which the albuminuria may be explained. While, therefore, there is a positive basis of facts for the assumption that quantitative changes in the composition of the blood may, under certain circumstances, cause albuminuria to appear, or increase this symptom if already existing, the other assumption, hitherto maintained only by the supporters of a heematogenous albuminuria, to the effect that the sym- ptom in question has its origin in qualitative changes in the albumen of the blood, can claim no equally definite and positive facts as a foundation but only sundry reasons which invest it with a certain amount of probability. This, how- ever, holds good only with regard to the pathological albuminuria, for there is a certain kind of physiological albuminuria which is doubtless a result of qualitative changes in the albumen of the blood. This is the albumi- nuria which occurs after the introduction of egg-albumen into the blood—and not merely after the immediate introduc- tion or its injection under the skin, as often done in experi- ments, but likewise after its introduction into the stomach. Many observers, namely T6gart, Brown-Sequard, Becquerel,