Albuminuria and Bright's disease.

  • Tirard, Nestor Isidore Charles, Sir, 1853-
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: Albuminuria and Bright's disease. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    tlie renal affection, and in such cases the trouble seems to have started from the bladder, and to have given rise to an ascending neuritis. The subsequent course of any case depends largely upon the direction in which the purulent discharge occurs. The pro- gnosis is somewhat more hopeful when the abscess opens into the pelvis of the kidney; this may lead to an ammoniacal condition of the urine, but as the flow of pus gradually ceases the urine returns to its normal reaction. Sometimes the abscess burrows in new directions, and it may discharge itself through the intestine, through the liver into the bile ducts, or through the pleura into the lung. When the discharge occurs through the lung substance, the pus expectorated is peculiarly foetid, and the patient rapidly becomes exhausted by the nausea and discomfort induced. ]\Iany cases of suppurative nephritis pass on by gradual stages to the development of lardaceous disease, and to a condition of extreme cachexia, which is associated with hectic rises of temperature. Sometimes the termination of the case is marked by typhoid symptoms, the tongue becoming dry and coated, the patient suffering from frequent diarrhoea, and, in addition, from low muttering delirium, alternating with headache and other symptoms of depression. These symptoms are sometimes referred to uremia, and undoubtedly to a large extent they may imitate the symptoms commonly associated with chronic ursemia. From the frequency with which suppuration in the kidney is associated with ammoniacal decomposition in the urine, these typhoid symptoms have been referred to a form of ammoniacal poisoning. There is no doubt, however, that the typhoid condition above described may occur without any evidence of alkaliuity of the urine, and it is there- fore more probable that, like the symptoms of puerperal eclampsia, typhoid symptoms are to be referred to auto- intoxication, from the development and absorption of some toxic agent in the course of the suppuration. Prognosis.—The prognosis of suppurative nephritis is to a large extent dependent upon its cause. When it is the result of pyaemia or septicsemia it adds largely to the risks of the primary disease ; at the same time, when the collection of pus