Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

54/440 (page 38)

when the transudation is stemmed in consequence of impedi- ments to its escape and its albumen is increased owing to the absorption of water^ and when, lastly, this stemmed-up, copiously albuminous, fluid compresses the glomerular vessels, and forces them away from the capsule. The albumen thus becomes visible, but by no means always in every capsule, even where they are all involved, though in varying degrees of intensity, in a diffuse process, but it very frequently happens that only more or less of them present traces of albumen, the remainder being apparently free from it, because the accu- mulation has not been sufiB.cient to make itself visible. Very instructive in this respect is the condition which is produced after prolonged stagnation of urine^ the result of applying a ligature to the ureters. Here at a certain period (see S. Ill) we find the nrinary tubules and the capsules distended, and in several of the latter the glomerular vessels forced back by coagulated albumen, in others by a more or less broad and clear ring of fluid without any visible trace of coagulated albumen. This fluid must, however, be albu- minous, and it does contain albumen (as appears on examina- tion of the urine obtained immediately after the ligature has been removed from the ureters), and much more than there can possibly be in the normal transudation under the most favorable hypothesis. And as, notwithstanding this, it appears clear and transparent, we cannot expect, as a general rule, to see coagulated albumen, or anything more than a small clear ring, between the glomerulus and the capsule.^ It follows, therefore, that there is at present no reason for supposing that microscopical examination can furnish any proof of the presence or absence of albumen under normal 1 The application of a ligatm-e to tlie ureters of rattits can be so easily and neatly efEected, that any one may convince himself without any great difficulty of the correctness of the above statement. The best proof, how- ever is furnished by a repetition of Posner's own description of the appear- ances which the kidneys present after ligature of the ureters for two or four hours, after which we know, and Posner himself asserts, they are m a state of acute congestion, and red blood-corpuscles (?) are mixed with the secre- tion On microscopical examination in this initial stage, besides the excessive capillary hyperajmia and partial hemorrhages, all that is seen is dilatation of the urinaiy tubules, but there is no coagulable exudation and no unequivocal casts.