Diseases of the kidneys and of the spleen, hemorrhagic diseases / by H. Senator and M. Litten ; edited, with additions by James B. Herrick ; authorized translation from the German, under the editorial supervison of Alfred Stengel.

  • Hermann Senator
Date:
1905
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the kidneys and of the spleen, hemorrhagic diseases / by H. Senator and M. Litten ; edited, with additions by James B. Herrick ; authorized translation from the German, under the editorial supervison of Alfred Stengel. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    the possible variations of renal inflammation. These variations give rise to a certain multiformity of the clinical picture, but are not constant enou2:h to justify a greater refinement of classification. [The question of the classification of inflammations of the kidney is an extremely complicated one. Neither clinically nor from the stand- point of etiology or morbid anatomy can the cases be grouped in a manner entirely satisfactory. Of the chronic varieties, for instance, cases are seen that are from the clinical aspect typically of the paren- chymatous type and are found to be such at the autopsy; others are unquestionably of the primary chronic interstitial variety. But many cases partake of the characters of each of these two groups and are diffuse in nature. We must often be content with the diagnosis of chronic diffuse nephritis or chronic nephritis without attempting to fit the case more accurately into some particular subclass that is, after all, more or less artificial. These sensible and conservative views of Senator will, we think, be heartily applauded by both pathologists and clinicians. It seems useless also to worry too much over the proper use of the term Bright's disease. Can it not be a term broadly, even loosely, applied to cover all the diseases called nephritis—i. e., those non-sup- purative forms just classified ? To be sure. Bright made no such classi- fication, but referred particularly to the types in which edema and albuminuria were striking features of the diseased condition of the kidney. Fine distinctions between acute nephritis and acute Bright^s disease—the latter with edema—can be made, and successfully, too;^ but it seems, after all, to complicate rather than simplify matters, and w^e prefer to speak of the condition as nephritis or as Bright's disease, using the terms interchangeably, although recognizing that some forms of nephritis are degenerative or atrophic in character, and not in the strict sense inflammatory, and that some cases called Bright's disease are different from anything described by Bright.—Ed.] ACUTE NEPHRITIS. The forms included under this head correspond in general to those described by the older authors, especially Frerichs, as the first stage of Bright's disease or acute Bright's disease, and by other authors as acute parenchymatous or epithelial, desquamative, and some- times as superficial and transitory nephritis. ETIOLOGY AND PATHOGENESIS. The origin of the disease, in so far as its causes are known, must be ascribed to sudden changes in the blood which may be described as poisoning, in the wider sense of the term. The conditions in which such changes occur are : 1. The infectious diseases, especially those accompanied by fever. It is probable that there is not one of this class of diseases that is not under certain circumstances capable of bringing about acute nephritis, but they 1 See J. E. Bradford, Lancet, Nos. 4220 to 4223, 1904.
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