On the proximate cause of albuminous and dropsy, and on the pathology of the renal blood-vessels in Bright's disease / [Sir George Johnson].

  • Johnson, George, 1818-1896
Date:
1850
Catalogue details

Licence: Public Domain Mark

Credit: On the proximate cause of albuminous and dropsy, and on the pathology of the renal blood-vessels in Bright's disease / [Sir George Johnson]. Source: Wellcome Collection.

    5/16 (page 3)
    gorged with oil, and this is a condition which may readily he detected by an examination of the urine during life, when, as frequently happens, the desquamative process accompanies it. In other cases the cells are remarkably opaque, and appear to contain an unusual quantity of a finely granular material. I have observed this condition in the kidneys of diabetic sub¬ jects, in which cases, probably, the long-continued secretion of sugar has modified the action and appearance of the cells. It is of the utmost importance to bear in mind, that there is a most intimate relationship between a secreting-cell and its secreted product,—there is reason to believe, that a change in one will be invariably accompanied by a corresponding modi¬ fication of the other. The various changes in the secreting-cells, just now enu¬ merated, produce one common result; viz. an imperfect elimination of the renal secretion. The acute desquamative process rapidly fills the tubes with epithelial cells. The chronic desquamation destroys the life of the cells, arrests their reproduction, and leaves the tubes denuded.1 The fatty engorgement of the cells tends to obstruct the tubes, and so to impede secretion; and probably each visible de¬ viation from the normal appearance of the epithelial cells is attended by a corresponding imperfection in the perform¬ ance of their function. There are, besides, certain other morbid conditions, such as the replacing of the normal epithelium by a deposit of pus or unorganized fibrine in the tubes, which tend to the same result as the more common changes before mentioned. In every instance, excretion is imperfectly performed, and the urinary constituents are partially retained in the blood. From these preliminary remarks, I pass on to the main subject of this communication, which is to offer an expla¬ nation of two of the most common and important symptoms ol renal disease, viz. Albuminous Urine and Dropsy; and this will lead me to describe a remarkable pathological con¬ dition of the blood-vessels of the kidney, which, so far as I Know, has not hitherto been noticed. The observations which 1 Med.-Chirurg. Trans., Yol. XXX, p. 165 et seq.