Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

57/440 (page 41)

experiments, undesigned and yet potent conditions have been introduced,—conditions frequently overlooked, or their action erroneously interpreted,—we shall not be surprised that some of the experiments with regard to the influence of alterations in the blood-pressure have led to results mutually contra- dictory, while others, even where the results were congruent, as, for example, in venous congestion, have had very discordant explanations attached to them. The conditions with regard to the increase of blood- pressure in the arteries are the simplest and plainest of all, yet the influence of this change upon the production of albuminuria has been made the subject of very different statements by the various investigators. It is true that many of the experiments have either been incorrectly performed, or they lead to a conclusion just the opposite to that which their performer deduced from them. If, taking our stand upon pure theory, we ponder over the views developed in the foregoing pages, and reflect upon the necessary conse- quences of the increase of arterial pressure within the kidneys, we find that the result must be a combination of the influence of the increase of pressure upon the transudation from the glomerular vessels, and of the influence upon the secretory elements of the uriniferous tubules. The condition of the transudation may be predicted with perfect certainty, it will, as has been already explained (see p. 28 et seq.), be more copious than under normal conditions, and its percentage of albumen will be diminished. The condition of the proper secreting elements of the kidney cannot be predicted with a like certainty, for they cannot be subjected to a separate experimental test, as is the case with the elements of other glands. Following, however, the analogy of other glands, especially the liver, we may assume that with the increase of arterial pressure (and of the rapidity of the current) the secretion will, at all events, be increased up to a certain point, and no albumen will appear therein. The result, as regards the urine, will be an increase in its quantity ; on the other hand, it will contain a still smaller percentage of albumen than is assumed to be normally present. If we take, as before, the percentage of albumen in the transudation as a, it will, under the assumed conditions, be and the