The clinical examination of the urine in relation to disease / by C. Black.

  • Black, C.
Date:
1870
Catalogue details

Licence: Public Domain Mark

Credit: The clinical examination of the urine in relation to disease / by C. Black. Source: Wellcome Collection.

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    scope, our knowledge of urinary pathology has, of late years, considerably advanced. But our greatest lack of information is in the observance and appreciation of those changes which disease produces in the quantity, density, and colour of the urine, and of the nature and constitution of the deposits which occur in it, as well as of the adventitious products which are held in solution or suspension by it in some or all of the phases of disease. In this particular direction there is great need for future enquiry, which, if properly carried out, would lead to very important practical results. In entering upon this particular subject, which may not inaptly be termed the semeiology of the urine, a knowledge of healthy urine, as to its daily quantity, density, colour, chemical constitution, and as to the variations which these may undergo within the range of health, is absolutely necessary, in order that those deflections from health which occur more or less in disease, may be recognised, appreciated, and made the ground for legitimate deduction and treatment. The kidneys are one of the great highways along which the exhausted tissues are conveyed from the body. They are no less the channel by which substances incapable of entering into the formation of the organism, are removed either unaltered in the condition in -which they were presented to the system, or after having undergone a certain change or metamorphosis in their mole ■ cular arrangement and chemical constitution. The function of the kidneys is therefore highly conservative of health and of life. Let this function be so deranged that the elimination of urea bears no proportionate ratio to the destruction of tissue which is taking place in the body, and serious results at once occur. These may issue in violent sickness and vomiting, in severe frontal headache, in convulsions, in coma, and in death, according to the interruption which exists to the eliminating power of the kidneys and to the consequent retention in the blood of the pro- duct of the conversion of even healthy tissue into urea, which thus becomes a deadly poison to the body, of which its previously ar- ranged elements, in the form of muscle, formed a component part. Every practical physician is well acquainted with the rapidity with which these results take place in acute nephritis, and in the latter stages of granular degeneration of the kidneys. Here, in the one instance, the secretory portion of the kidney is suddenly invaded by inflammatory exudationin the other instance, exuda- tion more slowly, yet progressively, occurs ; in both, the proper