Cases and observations illustrating inflammatory effusions into the substance of the lungs, particularly as modified by contagious fevers / by William Aitken, M.D.

  • Aitken, William, 1825-1892.
Date:
1848
Catalogue details

Licence: Public Domain Mark

Credit: Cases and observations illustrating inflammatory effusions into the substance of the lungs, particularly as modified by contagious fevers / by William Aitken, 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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    connected with the temporary albuminuria sometimes found to exist during the progress of typhus fever, as well as during exudations into organs such as in pneumonia. Dr Finger of Prague has found albuminuria, independent of renal disease, to exist in 155 cases out of 600 of various acute diseases, and that, next to tuberculosis, the temporary albuminuria occurred most frequently during typhus fever; next to which, in the order of frequency, followed puerperal fever and pneumonia. That in those cases of typhus fever which proved fatal, the intes- tinal complication existed in most, and the pulmonary in the re- maining. We also find his researches showing that the albumen appeared in the urine generally from the sixteenth to the twenty- fifth day, while the disease was on the increase or at its height. In those who recovered, it uniformly declined and disappeared during convalescence. In 9 out of 15 cases of pneumonia, it disappeared during recovery. In 6 who died, no disease of kidney could be detected. In 26 cases of typhus fever, in which exten- sive exudation had also taken place into the lungs, I examined the urine in each, and found temporary albuminuria to exist in 6; and the following table (see next page) shows the conditions of the urine and stage of the disease at which the albuminuria ap- peared. Of these six cases three recovered and three died, but in all of them, Avith the exception of one, the albumen disappeared, and in none was there any evidence of renal disease. In all the cases the albumen appeared on an average about the sixteenth day of the fever, and about the sixth or seventh day after exudation had occurred in the lungs. The average density of the urine appears to have been about 1024 at the time of coagulability. The disappearance of the albumen appears always to have been followed by a more or less abundant crystalline deposit, when the average density diminished. Dr Finger, from his observations, concludes that the presence of albumen in the urine, along with fibrinous or purulent products of exudation into any organ, is in consequence of these products of exudation becoming absorbed and eliminated again as albumen by the kidneys. There is some inconsistency, however, about such an explanation, when we find that the albumen is invariably present in the urine during the exudation, formation, or organization of the exuded matter, in whatever organ it may take place, and that, during the resolution of this exuded matter, the albumen is absent at the very time when the products of exudation are being ab- sorbed into the current of the circulation, and associated with an abundant crystalline deposit in the urine. From my own obser- vation, I am inclined to regard the existence of albumen in the urine unconnected with renal affection as a symptom or part of