On the diseases of the kidney : their pathology, diagnosis, and treatment; with an introductory chapter on the anatomy and physiology of the kidney / by George Johnson.

Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: On the diseases of the kidney : their pathology, diagnosis, and treatment; with an introductory chapter on the anatomy and physiology of the kidney / by George Johnson. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    and potatoes; during the remaining three days he took meat as usual, perhaps rather in excess. Under this plan of diet he found himself getting thin and weak, and he became very dyspeptic and flatulent after his meals. About a fortnight before his illness actually commenced, he left off a thick upper coat which he had previously worn, and on several occasions, in coming home at two o^clock in the morning from his miserable occupation, he felt the cold very piercing, and suffered a decided chill. On Easter Monday, April 5, he felt drowsy, and had muscular pains. The next day, general dropsical swelling appeared, and the urine was very scanty. He con- tinued to get worse until the 12th April, when he first came under my notice. He was a well-made, tall, and muscular man, had slight general dropsy with pallor of the face, head- ache, drowsiness, and thirst. The urine was scanty and dark- coloured, almost solid, with albumen when boiled, sp gr. 1020. It contained numerous ‘ epithelial casts^ {i. e. fibrin entangling entire epithelial cells, see fig. 8, p. 89), scattered epithelium and blood corpuscles. The sounds of the heart were normal. He was treated by cupping on the loins, followed by warm baths, purging, and diaphoretics. Under this plan, with low diet, he soon began to improve, the dropsy diminishing, and the urine becoming more abundant and less albuminous. A careful microscopic examination of the urine was made almost daily. Its character continued the same as above reported until the 29th April, when, for the first time, it was observed that many of the epithelial cells contained oil- globules. At that time I knew much less of the history of this disease than I now do, and in my ignorance I despaired of the patient's recovery.* Day after day the oil was visible, some cells being quite filled with it; but at the same time, by far the greater number of cells contained no oil, and this is the fact which, with my present knowledge of the cases, would have suggested to me a very hopeful and favourable prognosis. * See Med. Chir. Trans, vol. xxx. p. 185.