Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

75/440 (page 59)

BO marked changes can be possitively detected under tlie microscope, but this is clearly no proof that the cells have escaped all injury, for the glomerular vessels appear un- changed, notwithstanding the fact that blood and albumen have escaped from them in appreciable quantities. The appearances are of a different and more simple character when the flow through the vein is checked for a very short period only, the obstruction being removed before the symptoms have reached their acme. We are indebted to Ludwig, whose studies on the secretion of urine led him to try the effect of these very brief interruptions to the venous outflow, for a knowledge of the very important fact that the closure of the renal vein (the arterial supply con- tinuing unchanged) causes the uriniferous tubules of the pyramids and medullary substance to be compressed by the much dilated veins surrounding them, even to the extent of producing complete closure, so that the flow of urine may be interrupted, to be immediately renewed when the blood, is allowed to flow. In such a kidney, removed from the body immediately after ligature of the vein, all that can be recognised, both with and without the microscope, is great dilatation of the numerous vessels of the renal medulla, but no excretion of albumen, none at all events in the Bowman- Miiller's capsules. If the vein is allowed to remain occluded for a somewhat longer period, for eight to twelve or at most fifteen minutes, the changes will be found to have advanced a step further—there is now distinct excretion of albumen in the kidney, but this has taken place exclusively, or very nearly so, in the uriniferous tubules, particularly of the medul- lary substance, in the collecting tubes, but not in the capsules. The appearances are very beautiful and distinct on sections, doubly coloured with picro-carmine, of the renal tissue hardened by boiling with or without subsequent treatment in alcohol. Everywhere within the tubuli we see the tiny coagula of albumen with shrivelled blood-corpuscles, whereas in the capsules we look in vain for albuminous deposits; perhaps here and there an isolated specimen may be found, if the experiment has been somewhat more prolonged.^ If the ligature bo retained for more than the brief interval