On some diseases in which albuminous urine occurs / by Thomas Williamson.

Date:
[1841]
Catalogue details

Licence: Public Domain Mark

Credit: On some diseases in which albuminous urine occurs / by Thomas Williamson. 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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    Previous to bringing forward cases for the purpose ol proving the frequent existence of albumen in the renal secretion, altoge- ther independent of any change of structure occurring in the kidney, it may, perhaps, be well shortly to advert to the opinions expres- sed by various authors of eminence as to the extreme rarity of its occurrence. Dr Osborne states, in connection with this subject, “ in no instance have I met with eoagulablc urine without dis- eased kidneys, or healthy kidneys with coagulable urine. ’ Dr Christison states, that, although coagulable urine may be found without kidney disease, it is, nevertheless, “ very rare.” M. Rayer is said to have examined the urine of 400 patients taken indiscriminately, the result of which was, that only three present- ed albuminous urine without granular kidney. M. Solon ex- amined the urine of 500 or 600 persons either in health or full convalescence, and found only one with albuminous urine. And lastly, Professor Forget, on two different occasions, examined the urine of between 40 and 50 patients in his hospital, and “ found albuminous urine only in those affected with dropsy, and in whom, when they did not recover, the inspection proved the existence of diseased kidneys.”* On the other hand, among those Avho strongly contend for the frequent appearance of albuminous urine without kidney disease, we may mention the name of Dr Darwall, who illustrates his posi- tion by several cases, one or two of w’hich we now call attention to. Talking of effusions which frequently attend diseased states of the heart, he observes : Case I.—“ In a patient who died in the Birmingham Hospital, during the present year, at a very early stage of the effusion, two months before his death the urine was barely rendered turbid, but the evening he died it was nearly rendered solid by boiling. On dissection, the heart was found enormously enlarged, and the aor- ta very much diseased, the kidneys were perfectly sound.” Case II.—Another case “ occurred in a lady who had been suffering from pulmonary symptoms, and symptoms of disease of the heart for nine months. When we first saw her, at this time, the urine coagulated strongly, and continued to do so till the pe- riod of her death, three months afterwards; yet, while the left lung, the pleura, and the heart, exhibited serious disease of long standing, and while the liver was also diseased, though in a slighter degree, there was no appreciable change whatever in the substance of the kidneys.”f The three following are cases of pneumonia, and occurred in our own experience. See Christison on the “ Granular Kidney,” page 39. 4 Cyclopaedia of Practical Medicine, Vol. i. Article “ Dropsy,” p. 637 and 640.