Clinical bacteriology and haematology for practitioners / [Walter D'Este Emery].

  • Emery, Walter d'Este, 1870-1923.
Date:
1908
Catalogue details

Licence: Public Domain Mark

Credit: Clinical bacteriology and haematology for practitioners / [Walter D'Este Emery]. Source: Wellcome Collection.

    190/344 (page 134)
    [There are also characteristic chemical changes in uraemia, to which I have paid a good deal of attention of late. In health the cerebro-spinal fluid contains about 0*035 to 0*04 per cent, of urea, o*7 per cent, of chlorides, and has a freezing-point of — 0*56° C., or thereabouts. In renal disease in which the kidneys are acting well these figures are but slightly disturbed, but in uraemia there is abundant evidence of retention of soluble substances. The urea increases greatly—the maximum I have seen being 0*4 per cent.— the chlorides may rise to 1 per cent., and the freezing-point is depressed. I believe this to be the simplest test of the functional capacity of the kidney, the chemical examinations being easy in a substance of such simple constitution as the cerebro-spinal fluid. It is occasionally of value in patients found unconscious. In one such case I was able to exclude uraemia definitely, though the urine contained albumin and casts : it turned out to be a case of poisoning. In uraemia there is often the additional advantage of its affording a relief to some of the symptoms. Further details are outside the scope of this work.] (d) Bacteriological.—The chief organisms which cause acute meningitis are given in the following table, which is modified from one given by Osier : Primary (i.e., not dependent on an obvious lesion elsewhere in the body). 1. Cerebro-spinal fever— (£>) Ep0^^0 jWeichselbaum’s diplococcus, or meningococcus. 2. Pneumococcic— (a) Pneumococcic infection of meninges alone, not de-') pendent on disease of distant parts of the body. (b) Pneumococcic infection of meninges occurring as , part of a general septicaemia without obvious primary lesion. Pneumococcus. Secondary. A. To direct extension from local disease of the cranium, middle ear, fossae, spinal column, etc. Pneumococcus. Staphylococci. Streptococci, etc. B. To septicaemic infection due to disease in a distant part of the body. (a) Pneumococcic— Secondary to pneumonia, endocarditis, etc. Pneumococcus.