Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

73/440 (page 57)

ment of the blood has been completely arrested during many bours, and indeed, for days. As a matter of fact, the final result of all such experiments in which, bowever mucb tbe conditions are cbanged, one at last is always attained—tbe arrest of tbe circulation and of tbe renewal of tbe blood; I say, tbe final result of all sucb experiments is, as could be easily foreseen, always tbe same, namely, the escape of albumen and blood tbroughout tbe kidneys, and tbese pass into tbe urine when tbe secretion is again restored. But that under tbe various conditions wbicb induce congestion, tbe phenomena sbould develop tbemselves in an unequal degree might certainly a 'priori be regarded as more pro- bable than tbe contrary; it is also certain that tbese differ- ences could not be recognised if tbe cbanges were investigated only after they had become very far advanced, and tbe mis- cbief had thorougbly and universally affected all tbe various elements of tbe kidneys ; and in tbe last place it is no less certain that the course taken by tbe phenomena may be very different according as the disturbance is a sudden one or of a slow and gradual character. We know that all the organs, and tbe kidneys are no exception, are very sensitive to dis- tui'bances of the circulation, but notwithstanding this fact, when tbe disturbance is of a gradual character, tbey accomo- date tbemselves very well to tbe altered conditions, and witbin certain limits can discbarge tbeir functions in a manner approximatively normal. A consideration of all tbese facts will prevent us from expecting, on tbe one band, any uniform course of tbe phenomena in the experiments on con- gestion, and, on the other, any collective and individual coincidences between the clinical appearances of renal con- gestion and those experimentally induced. If the escape of venous blood be completely prevented by tying the renal vein, or by any otber plan wbicb does not at the same time arrest tbe action of tbe heart, inasmuch as blood will be supplied as freely as before, tbere must neces- sarily result the fullest imaginable engorgement of the organ with extravasations of blood due to lacerations of tbe smallest vessels, and tbe only limit to this engorgement will be the distensibility of the renal capsule. In rabbits, for example, this limit appears to be reacbed when the escape of blood