On the co-existence of granular disease of the kidneys with pulmonary consumption ; and on the influence of the strumous diathesis in predisposing to renal disease / by Thomas Bevil Peacock, M.D.
- Thomas Bevill Peacock
- Date:
- [1845?]
Licence: Public Domain Mark
Credit: On the co-existence of granular disease of the kidneys with pulmonary consumption ; and on the influence of the strumous diathesis in predisposing to renal disease / by Thomas Bevil Peacock, M.D. Source: Wellcome Collection.
Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.
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![on Phthisis,], states, that the kidneys had undergone the granular disorganization in 4 cases; but as he has not reported the condi- tion of these organs in his table, we are unable to ascertain the proportion which these bore to the whole of those examined.1 2 The granular disease of the kidneys seems to be a more frequent com- plication of phthisis, than the deposition of tubercle in those or- gans. Dr Home did not find tubercles in the kidneys in any of the subjects which he examined ; of the cases reported by Dr Reid, 3 only appear to have been so affected; and in the observations which I have myself made, tuberculous depositions were found in the kidneys in only 6 or 10T per cent. The renal complication would therefore appear to occupy an intermediate position, as to frequency, between the almost constantly occuri’ing secondary affections of the intestinal follicles, and of the mucous membrane of the larynx and trachea, and the depositions of tubercle in the vis- cera, which, after adolescence at least, are extremely rare.3 In the whole of the cases in which the granular disease of the kidneys occurred as a complication of phthisis, the tubercle had softened, and given rise to caverns—in 3 instances in one lung only, in the remaining 5 in both. In 4 cases, there existed more or less extensive recent pneumonic condensation in one or both lungs, and in 2 the pleura was also found covered by recent membranous exudations, and its sac con- tained sero-purulent fluid. In a 5th case there existed copious muco-purulent secretion in the bronchial tubes, and the mucous membrane was much injected. In 7 cases the solitary and aggre- 1 Edinburgh Medical and Surgical Journal, vol. xlix. p. 1. 2 It is curious, notwithstanding the evident frequency with which the renal disease occurs as a secondary affection in pulmonary consumption, that no allusion should be made to the subject by M. Louis, in the last edition (1843) of his Recherches sur la Phlhisie. 3 From an analysis of 97 examinations of phthisical subjects performed by myself, I find the relative frequency of the several secondary affections to be as follows: — The intestinal follicles contained yellow tuberculous matter, or were ulcerated in 85'3 per cent. The mucous membrane of the larynx, or trachea, was found ulcerated in 70 per cent. A larger or smaller number of tubercular masses were found imbedded in the sub- stance of the kidneys, or in the mucous membrane of the pelvis and ureters in 1 O' 1 per cent. Tubercles were imbedded in the substance of the liver in 3T per cent. ,, ,, ,, of the spleen in 1’9 per cent, beneath the attached pericardium in 1'2 per cent. The substance of the heart is very rarely the seat of any heterologous deposit, and the deposition of tubercle in this situation seems especially rare. In the case here re- ferred to, there was a solitary mass of softish yellow tuberculous matter beneath the pericardium covering the right ventricle. I have seen one other instance in which numerous masses of tubercle, varying in size from that of a pin’s head to a split pea, had their seat apparently either in the sub-serous cellular tissue, or on the surface of the pericardium. This was in the case of a female, 28 years of age, whose lungs did not contain tubercle, though the bronchial glands were extensively diseased. This case forms almost the only exception which, out of several hundred examinations, I have found to the general law laid down by M. Louis, that if, after the age of 15, tubercles exist in any organ, they will also be found in the lungs.](https://iiif.wellcomecollection.org/image/b24930453_0013.jp2/full/800%2C/0/default.jpg)
