Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

74/440 (page 58)

has boon prevented for from half-an-hour to an liour. The kidney is then enormously swollen—to double its normal size or more—and in addition to extravasations varying in size and number, its entire substance, cortical and medullary, i& turgid with blood. After the organs have been hardened by boiling, according to Posner's method, and then coloured, microscopical examination shows that coagulated albumen and numerous red blood-corpuscles are deposited in the cap- sules and in the uriniferous tubules. The same appearances are found, according to Posner, when the inferior vena cava and not the renal vein is tied, and the same holds good, par- ticularly with regard to the excretion of albumen (to antici- pate further statements on this head), in every form of con- gestion due to other causes, provided only that the condition be of sufficient intensity and duration, stopping short, how- ever, of causing the engorgement and extravasation of blood to attain the same degree. During the existence of such intense congestion, the function of the kidney is almost, if not altogether, in abeyance. In experimenting upon rabbits I could not succeed in obtaining any trace of secretion from the ureter of that side, if, before applying the ligature, the tube had been emptied of its contents. Cohnheim (59) states that immediately after the vein is tied a bloody liquid, highly albuminous, may at first distill from the ureter; this gradu- ally but decidedly diminishes, until at last the secretion entirely ceases. When the ligature is removed, supposing that it has not been retained for too long a time, the secre- tion is restored, and the fluid, as a matter of course, contains blood and a considerable quantity of albumen. How far this fluid, containing as it does so much albumen and blood, deserves to be called urine, is a question which may be left undecided. An experiment of this kind can, as I have already said, teach us nothing with regard to the order of sequence of the process of the development of the albuminuria, especially upon what it depends. The production of such an intense congestion injures more or less all the elements concerned, the glomerular vessels, the interstitial vessels, the various epithelia, and possibly other constituents of the tissue. With regard especially to the tubular epithelium, it is true that