Causes of the hypertrophy of the vascular system in granular degeneration of the kidney / by Robert Saundby.

  • Saundby Robert, 1849-1918.
Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: Causes of the hypertrophy of the vascular system in granular degeneration of the kidney / by Robert Saundby. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    CAUSES OF THE HYPERTROPHY OF THE VASCULAR SYSTEM IH GRANULAR DEGENERATION OF THE KIDNEY. By ROBERT SAUNDBY, M.B. Edi.n., PATHOLOGIST TO THE GENERAL HOSPITAL, BIRMINGHAM. (Reprinted from the Edinburgh Medical Journal for October 1876.) It may be assumed as generally admitted, that in the bodies of persons whose kidneys present the appearances of advanced cirrhosis or granular degeneration, the vascular system shows tlie following abnormalities: dilatation and hypertrophy of the heart, dilatation and often chronic endoarteritis of the great vessels, hypertrophy of the muscular walls of the small arteries, witli thickening and dilatation of their perivascular sheaths. It is well established that increased vascular tension is one of the earliest phenomena of this disease—a fact which even cursory exploration of the heart and arteries reveals to every observer, and which the sphygmograph demonstrates with scientific precision; moreover, I think it is not going too far to say, that it is getting to be, if it is not already, the current opinion, that undue vascular tension is a prodromal symptom of granular degeneration of the kidneys; lastly, clinical observation has led to the connectino' together as antecedent O O and consequent that form of functional derangement of the liver which in some constitutions shows itself as gout, and in others is characterized by dyspepsia, accompanied by excessive excretion of lithates of soda and potash in the urine, with this condition of in- creased vascular tension. These being the clinical factors with which we have to deal, let us now see whether it is possible to deduce from them a satisfactory explanation of the foregoing patho- logical conditions ; and, in the first place, let us inquire under what „ physical and physiological circumstances similar states of the va^^, cular apparatus are apt to occur. Hypertrophy of tlie lieart i^^ pretty frequent pathological phenomenon, occurring in one or other chamber whenever that chamber meets with an unusual difficulty in discliarging itself, either from defect in the valves or from in- creased tension in the fluid contained in the cavity towards Avliicli it is propelling its contents. The facts are sufficiently familiar to make further illustration needless. Hy])eitrophy of the arterioles is not quite so familiarly known, as it is not observed exce])t when they are examined wdth tlie microscojie; but this condition IC -^1 'hU-