Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

120/440 (page 104)

little acceptance of late years, but for a reason whicb, if carefully scrutinised, will be found to be strictly of'an extrinsic and formal cliaracter. The invariable custom is to include in the term albuminuria nothing but the excretion of coagulable albumen from the blood, and, as before noticed, to consider that the excretion of other albuminous substances is not comprehended under the same term. In this sense the only recognised albuminuria, which assuredly depends upon a qualitative change in the blood, is that which is caused by the introduction of egg-albumen; but this is usually considered as devoid of significance in a clinical respect. And it is quite true that up to the present time our knowledge of this albuminuria has been derived from experiment and not from clinical observation. It is indeed possible that that which is brought about in a healthy man or animal by the ingestion of an excess of egg-albumen, may become developed in a diseased organism, especially in one which possesses abnormal capacity of digestion, by a moderate or even small amount of such food, and in that cas& this excretion of egg-albumen would certainly possess a clinical significance as well—the same significance as may perhaps be assigned to the ingestion of amylaceous food by a patient suffering from mild diabetes, who, when he avoids such food altogether or limits its quantity, excretes no sugar,, and in a general way shows no symptom of disease. It is well known that even healthy persons may be made to excrete sugar (glycosuria alimentaria) by feeding them upon large quantities of sugar and starch, and since this fact does not induce us to remove the so-called mild form of diabetes from the category of pathology, there is no greater amount of objection to regarding this excretion of egg- albumen as devoid of significance in a pathological respects The question would be to determine the boundary between moderation and excess of supply—obviously a diflSicult task. With regard to the other albuminous substances which occur in the urine, not merely in the course of experiments, but likewise under purely clinical conditions in various forms of disease, we are quite justified in separating hosmoglobi- nuria from albuminuria proper, inasmuch as the haemoglobin, as well as the colouring matters derived therefrom, does not