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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    [Albumin and casts are quite regularly found after hard foot-ball games. Blake and Larrabee ^ made some interesting observations on long-distance runners, and in the urine after the race (24 miles) albu- min was a constant finding. After the race every sediment contained large numbers of hyaline and finely granular casts, a few coarsely gran- ular and epithelial casts.—Ed.] But some cases develop independently of the above-mentioned causes, either as the result of repeated exposure to cold and from other unknown causes, or in connection, directly or indirectly, with acute nephritis, in the manner already described in connection with the etiology of the non-indurative form (see p. 224). The mechanism usually is that in the course of an acute infectious disease a more or less severe nephritis develops with or without dropsy, runs a favorable course, but leaves behind a slight, or frequently only intermittent, albuminuria which is overlooked or neglected, until after a time unmistakable signs of chronic nephritis make their appearance. These are just the cases referred to here, cases which differ from the ordinary form of indurative nephritis due to other causes, and which occur more during youth or even child- hood, and among which the female sex is more largely represented than among the forms which develop later in life. The incidence among women is somewhat increased by the fact that many of these cases have their starting-point in the nephritis of preg- nancy. These cases, which, strictly speaking, represent a secondary induration or contraction of the kidneys, are usually regarded as primary because, owing to the insidious course, the demonstration of a causal connection with an acute nephritis, which may have occurred years before, is diffi- cult if not impossible. They cannot, in fact, be separated from those cases which are not preceded by an acute aifection, are insidious from the beginning, and run their course as a true primary chronic nephritis —another proof of the gradual merging of one form of kidney disease into another. Hereditary or family predisposition, while rare, sometimes undoubtedly occurs. The most interesting observations bearing on this point are the following: Dickinson -^ reports the history of a family in the first generation of which 2 sisters for many years had albuminuria and died at the respective ages of forty- eight and forty-nine. Of the 4 children of their brother, 1 son had albu- minuria for fourteen years and died at the age of twenty-six; a daughter died after suffering from the same disease at the age of thirty-four; and 2 other daughters afflicted with the same disease were still alive at the ages of thirty-eight and forty years respectively. In the third generation, which consists of 6 chil- dren of these deceased nieces, 5 have albuminuria; 1 daughter, twenty years of age, since the ninth month of life; 1 son, twenty years of age, for an unde- termined length of time; 1 son, fourteen years of age, since early childhood; 1 son, fifteen years of age, for two years; and 1 daughter, five years of age, since the sixth month of life. J. Tyson ^ knows a man, thirty years of age, a sufferer all kinds and renal epithelium, as in acute or parenchymatous nephritis. Of 8 trained bicyclists, 7 were found to have albuminuria at the end of the run, and 1 cylindruria. Hyaline, granular, and epithelial casts, as well as leukocytes, were also found in 5 out of the 7. ' Boston Med. and Surg. Jour., clxviii., Feb. 19, 1903. ^ Loe. cit., p. 378. * A Treatise on Bright's Disease and Diabetes, Philadelphia, 1881, p. 166.
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