Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

92/440 (page 76)

7C arterial supply is artificially cut off, and are most satisfac- torily explained by those processes whicli are induced by this experiment, as above described (see p. 63), These are, the great diminution of tbe water as the aggregate result of de- crease in pressure upon tbe filtering and secreting apparatus, tbe diminution of the specific constituents of urine as repre- sented by urea, the small proportion of albumen present, the total absence of blood, or its presence in very minute quan- tities. Considering tbe experimental and clinical facts, it is not necessary to discuss the influence of an alteration in tbe nutrition of the epithelium and vascular walls upon the com- mencement of the process, even when the arterial supply is completely cut off, and it is still less necessary to do so when the supply is reduced but not entirely abolished. M. Hen-mann as well as v. Overbeck noticed the appearance of albumen in the urine a few seconds after they had tied the renal artery, and they also observed that it disappeared after a very short interval, even within half-an-hour. It has been already mentioned that the circumstances are often very similar in the human subject, and that the urine changes, so to speak, at once when the circulation becomes regu- lated, being more abundant in quantity, and exhibiting no trace of albumen. It would be necessary to magnify con- siderably our notion of disturbed nutrition and to regard every disorder of the circulation as coming within this cate- gory, if in cases like these we attempted to attribute the rapidly appearing and transient albuminuria to deranged nutrition of the elements of the tissues. It is, moreover, difficult to reconcile the scanty excretion of albumen and the very slight admixture, if any, of blood in the urine, with the assumption that there is any disorder of nutrition in the glomerular vessels or their epithelial investment. It would, however, be improper to deny that, as time goes on, disturbances of nutrition become a prominent feature in the congestion we are now discussing. It is certainly difficult or even impossible to specify the degree to which the arterial supply must be reduced in order to cause nutritional disturbances, and therefore in forming an estimate of this influence considerable latitude must be allowed to individual discretion. According to the stand-point which an