Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

89/440 (page 73)

contains blood and abundance of albumen, is not at all in accordance witli facts, and there is, by no means, the most perfect harmony between clinical observations and the experimental venous occlusion, as is generally pretended. For these reasons it will not be superfluous to describe somewhat minutely the urine of congestion, as it daily comes before us in disease of the circulatory or respi- ratory organs, and such a description will be useful for another reason, viz. because certain changes in the urme, especially with reference to the proportionate amount of its several constituents, and which may be of importance in the explanation of the processes going on in the kidney, can be determined in a satisfactory manner only in the human subject. The first and most constant phenomenon is the diminution of the water, and therefore of the quantity of urine, this being determined by the amount of water present. There is little known with regard to the proportionate amounts of the solid constituents, but the total quantity of these is not diminished in the same proportion as the^water. On this account the specific gravity of the urine is increased, its colour becomes deeper, and there is a tendency to the formation of sediments, these being due to the fact that the urates, which are not very soluble in cold water, and uric acid itself, are readily precipitated during cooling from urine which contains less than the normal amount of water. It is, however, more than probable that the solid constituents, or at all events a portion of them, are excreted in diminished quantities, although their diminution does not proceed fari passu with that of the water, and they may therefore be relatively in- creased with reference to that fluid. The urea at least, according to my observations, is always absolutely diminished in quantity, notwithstanding the relative increase, which may amount to three or more per cent.^ The condition of the ui-ic acid is more difficult to estimate, inasmuch as the respi- ratory troubles almost always present in this form of renal congestion, give rise to complications which apparently exert ^ The absolute diminution of the uvea can partly be explained by the fact that less nourishment is taken and absorbed, and partly also by the consideration that the urea finds its way into any dropsical efEusions that may be present, and into the discharges from the bowels.