Volume 1

A text-book of human physiology : including histology and microscopical anatomy with special reference to the requirements of practical medicine / by L. Landois ; translated from the seventh German edition with additions by William Stirling.

Landois, L. (Leonard), 1837-1902. Lehrbuch der Physiologie des Menschen. English

Date:: 1891

Credit: A text-book of human physiology : including histology and microscopical anatomy with special reference to the requirements of practical medicine / by L. Landois ; translated from the seventh German edition with additions by William Stirling. Source: Wellcome Collection.

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$tion may take place within the bladder, when the urine always contains pus-cells (fig. 323) and detached epithelium. When much pus is present, the urine contains albumin. Ammoniacal urine forms white fumes of ammonium chloride, Avlien a glass rod dipped in hy- drochloric acid is brought near it. [When ammonia is added to normal urine, triple phosphate is precipi- tated in a feathery form (fig. 341).] [Significance of Triple Phosphate.—If urine be alkahne 318. when it is passed, and the alkalinity be due to a volatile alkali, MiVvnonnpno iivp^ i.e., to NH3, then decomposition of the urine has taken place, and miciococcus uie*. this kind of urine is a sure sign that there is disease of the genito-urinavy mucous membrane.] 264. ALBUMIN IN URINE OR ALBUMINURIA.—Serum-albumin is the most important abnormal constituent in urine which engages the attention of the physician. It occurs in blood (§ 32), and its characters are described in § 249. [In some cases, perhaps in most cases, serum-globulin is present along with serum- albumin. 1 of Albuminuria.—1. Serum-albumin may appear in urine without any apparent anatomical or structural change of the renal tissues. This condition has been called by v. Bamberger ''Hoimatogenous albuminuria, and by Leube physiological albuminuria although the latter term is not a good one. It occurs but rarely, however, and sometimes in healthy individuals when there is an excess of albumin in the blood-plasma {e.g., after suppression of the secretion of milk), and after too free use of albuminous food. 2. As a result of increased blood-pressure in the renal vessels, e.g., after copious drinking. It may be temporary or it may be persistent, as in cases of congestion following heart disease, emphysema, chronic pleuritic effusions, infiltrations of the lungs, and after compression of the chest, causing conges- tion in the pulmonary circuit, which extends even into the renal veins, &c. 3. After section or paralysis of the vaso-motor nerves of the kidneys, which causes great congestion of these organs. The albuminuria, which accompanies intense and long-continued abdominal pain, is brought about owing to a reflex paralysis of the renal vessels. 4. After violent muscular exercise. [Senator found that forced marches in young recruits were very frequently followed by the appearance of albumin in the urine, which persisted for several days.] Convulsive dis- orders, e.g., epilepsy, the spasms of dyspnoea after strychnin poisoning, in shock of the brain, apoplexy, spinal paralysis, and violent emotions ; the excessive use of morphia, which perhaps acts on the vaso-motor centres. 5. It may accompany many acute febrile diseases, e.g., the exanthemata (scarlet fever), typhus, pneumonia, and pysemia. In these cases it may be due to the increase of temperature paralysing the vessels, but more probably the secretory apparatus of the kidney is so changed {e.g., cloudy swelling of the renal epithelium) that the albumin can pass through the renal membrane. 6. Certain degenerations and inflammations of the kidneys at several of their stages. 7. Inflammation or suppuration in the ureter or urinary passages. 8. Certain chemical substances which irritate the renal parenchyma, e.g., cantharides, carbolic acid. 9. The complete withdrawal of common salt from the food. The albumin disappears when the common salt is given again. 10. The epithelium may be in such a condition that it cannot retain the albumin loithin the vessels, due to imperfect nourishment and functional weak- ness of the excretory elements. This includes the albuminuria of ischtemia, and that after haemorrhage, in anaemia, scorbutus, icterus, diabetes. [Grainger Stewart finds that albunjinuria is more common among presumably healthy people than was formerly supposed.] [11. Besides the experimental conditions mentioned above, what is called experimental albuminuria may be produced by pressure on the renal vein, or by closing the renal artery for a short time and then removing the obstruction and allowing the blood to circulate. ] [Besides being derived from the secreting parenchyma of the kidney, albumin may be present owing to admixture with the secretions from any part of the urinary tract, including the vagina and uterus in the female. In some cases the transudation of albumin is favoured by changes in the capillary walls, the albumin being forced through by the intravascular pressure. Sometimes albuminuria occurs during the course of severe typhoid fever, and in acute fevers generally, where the temperature is persistently above 40° C. (104° F.). The high temperature alters the filtering membrane and permits the filtration of albumin.] [So-called. Physiological Albuminuria.—This term has been applied to that condition of the urine, where traces of albumin are found in individuals apparently in perfect health. Johnson and Pavy cite such cases, while Posner asserts that all urine—even healthy urine—contains traces of Proteids, whose presence is ascertained after concentrating the urine. It is safe to assume that normal urine should give no reaction with the usual tests for albumin. Posner precipi- tated the urine with alcohol, washed the precipitate, dissolved it in acetic acid, and tested it,$