Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

78/440 (page 62)

liave not made any expoinments with regax'd to the first appearance of albumen and its distribution under these circumstances. With regard to the condition of the urine, the fact is not without significance that, contrary to what happens after the vein is completely occluded, viz., the almost invariable ap- pearance of blood in the secretion, this, in the case before us, is only an exceptional phenomenon. Stokvis discovered albumen, but no trace of blood, in the first specimens of urine passed after the circulation in the renal artery had been completely interrupted for a prolonged period. The albumen under these circumstances cannot have been yielded by the remaining healthy kidney, for, as Prerichs, Rosenstein and others have shewn (62) the complete removal of one kidney is not followed by albuminuria. We must, in preference, assume that, when the principal artery of the kidney is tied, the circulation is partially maintained by means of certain small arteries, and that a secretion of urine, certainly abnormal in its characters, goes on. To this category must be referred those instances in which, in consequence of a morbid con- striction of the small arteries, the supply of blood is checked and albuminuria results—^conditions which have been observed in the experiments previously alluded to (see p. 42) in which the irritation of the spinal cord, the poisonous effects ■of strychnia, dyspnoea, &c., were produced—and likewise the albuminuria observed by 01. Bernard (63), when he irritated the peripheral portions of the divided renal nerves. We may fairly assume that, in all these instances, there was an abnormal escape of albumen into the capsule while the spasm of the vessels continued, and that it was washed onwards by the subsequently restored current of blood. Blood may appear in the urine passed under these latter circumstances, just as it may in that which is secreted when the circulation is restored in the artery after complete interruption, for at this period the blood passes under abnormally high pressure through vessels more or less damaged as regards their nutrition, in consequence of the previously defective supply of blood,—conditions under which hajmorrhages are prone to occur. In connection with the above details we must, in conclu-