Selected monographs.

  • New Sydenham Society
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    111/440 (page 95)
    in the blood. These changes in the blood were supposed to be due to a morbid condition of the albumen, which, in consequence, differing from the normal albumen of the blood, passed into the urine ; and the cause of this morbid condition was sought for in some abnormal process of digestion or of tissue-change, or in the retention of excrementitious matters, <&c. But all that could be brought forward in support of these theories resolved itself into more or less obscure suppo- sitions or arbitrary assumptions, and consequently it was only to be expected that the theories which attributed the causa- tion of albuminuria to the condition of the blood—the theories of a hematogenous albuminuria—would be set aside in favour of a nephrogenous albuminuria, so that at the present day the former views have very few adherents (82). Moreover, it has been shown by the very ingenious experiments of Stokvis, that at least in ordinary cases of albuminuria and dropsy, or of so-called Bright's disease and amyloid dege- neration of the kidney, the albumen does not, certainly as a general rule, possess the power of inducing albuminuria in healthy kidneys. Albuminous urine, or the blood-serum of patients suffering from albuminuria, was injected into the blood or under the skin of healthy animals, and in twenty- one out of twenty-three experiments of this kind no albumen was found in the urine. In the two cases in which albumin- uria occurred, it was very remarkable that the urine used for injection had been taken from a patient suffering from albuminuria without demonstrable renal disease. The very cautious conclusion drawn by Stokvis is, that in the majority of cases a modification of the albumen of the blood is not the existing cause of the albuminuria, but that it must be left for further experiments to decide whether such may be the case under exceptional circumstances, as it is not improbable from a priori considerations (83). My opinion is, that this conclusion must be adopted in its entirety ; it corresponds even now, after nearly a decade and a half, with the actual state of our knowledge of the subject. That view especially must be rejected which attributes the occurrence of albumin- uria in renal diseases to changes in the blood, particularly in the conditions, including amyloid degeneration and conges- tion, formerly, and to some extent also nowadays, classified