Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

76/440 (page 60)

mentioned above, tlie conditions more and more closely approximate to those already described, and the excretion ■of albumen witbin the capsules generally is a manifest pbenomenon. At the same time, it is important to notice that tbe epithelial cells of the fcubules blocked-up by the masses of albumen are, like tbe epitlielium in general so far AS can be recognised, in a perfect state of preservation. Wben the interruption to tbe circulation is of such a brief character, no detachment of cells from the basement mem- brane can be made out, but if the congestion lasts a little longer, tbe epithelium is seen to be removed from its bed by a layer of coagulated albumen. No other conclusion can be drawn from these experiments than that the medullary substance of the kidney is that por- tion which is pi'imarily and most seriously affected when the renal vein is occluded, and tbe flow of blood through the artery allowed to continue ; and tbat the abnormal excretion of albumen first occurs in the uriniferous tubules of this portion, the visible escape of albumen into the capsules being a subsequent phenomenon. I do not know of any other way of intei'preting the appearances before us, for no one can be •expected to assume that the albumen is excreted into tbe capsules, and drains away into the tubules in tbe coui'se of a few minutes, and to sucb an extent that nothing beyond a mere trace, if even so much as tbis, remains behind in the capsules. There is nothing extraordinary in the fact that this conclusion has hitherto not been recognised, or that it should have been repudiated as illegitimate by experimenters, for as I have already said, the experiments hitnerto made have not been properly performed, at least with regard to our present purpose.-^ This explanation of the origin of the excretion of albumen when the renal vein is completely occluded for a brief period, during which some amount of circulation is probably kept up by other veins, can also be applied to explain the same I have shown in a former treatise (Z. c.) that the process of the excretion of altumen, when the flow through the vein is interrupted, goes on as ahove described, hut I then made no distinction between occlusion of the vein, without any change in the arterial pressure, and the same condition accompanied by a reduction of that pressure.