Relation between retinal hemorrhages and high arterial pressure / by L. Webster Fox and Warren C. Batroff.

  • Fox, L. Webster (Lawrence Webster), 1853-1931
Date:
[1909?]
Catalogue details

Licence: Public Domain Mark

Credit: Relation between retinal hemorrhages and high arterial pressure / by L. Webster Fox and Warren C. Batroff. Source: Wellcome Collection.

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    O O wW an n gQ 3.8 Wo WS o o = ay OR = e/a eas pas epee ye Mort a (vie) = ai y) ven > i) 35° a = aS 5 w = ee op) S - =f a8 Au to o De | of ve) o) | 9 ee) a 3 O ot fick 99 31 Albuminuric and hem- orrhagic retinitis 100 638 Retinal hemorrhage Eighty per cent. of the above cases occurred in diseases in which hyperten- sion is the rule, and, if not a constant accompaniment, the cardiac hypertrophy present would be sufficient under extreme exertion or emotion the arterial pressure to become decidedly elevated. By far the largest percentage of retinal hemorrhages were found in chronic inter- stitial nephritis—4o per cent.; arterio- sclerosis second, with 27 per cent., and chronic parenchymatous nephritis third, with 13 per cent. [he figures are sug- gestive in that it is to diseases of the kidney first, and of the arteries secondly, that our attention should be directed when seeking the cause of a given case of retinal apoplexy. This series will also serve to clarify existing knowledge upon the relative fre- quency of occurrence of these various causes which are usually merely listed in most text books, without reference as to which organ or system should be investi- gated first. Anemia—simple, pernicious, and leu- kemic, made up 6 per cent. of our cases, there being one case of spleno-myelogenic leukemia, in which hemorrhage is rather uncommon, and one early case of per- nicious anemia. In al] but one instance there were hem- orrhages of some type and the blood pres- sure, with one exception, was subnormal. Singularly, the cases of lithemia, 4 per cent., revealed only subconjunctival hem- Chronic paren- chymatous nepbritis Albumin exceés- sive. Numerous casts Chronic inter- stitial nephritis Albumin, trace Casts numerous orrhages; in none was it possible to deter- mine the presence of even minute retinal hemorrhages. A moderate degree of hypertension for the age was the rule. In two instances no other diagnosis could be made, but that of intestinal auto- intoxication, there being vertigo, per- sistent drowsiness, and an excess of indi- can and skatol found in repeated urin- alyses. Both were examples of hyper- tension; one showed hemorrhage, the other edema of the retina. Diabetic retinitis, with hemorrhages, furnished two cases. In both the blood pressure was subnormal; they belonging to the toxic group of causes of retinal apoplexy. Secondary syphilis, a comparatively rare cause of these hemorrhages, was the etiologic factor in two instances. On one, there was an accompanying iritis; on the other, beginning choked disc; in neither was the arterial pressure unduly high. The single instance in which aneurysm was apparently the only ascertainable cause, failed to manifest any abnormality of blood pressure, blood, or the kidneys. I am sure that increased arterial pressure is an important factor in the causation of acute glaucoma. It may be interesting to know that in one case of acute glaucoma, where the blood pressure was 265 cubic mm., twenty ounces of blood was taken from the right arm, when the pressure fell to 150 cubic mm. This patient had an attack of acute glau-
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