On the pathology and treatment of albuminuria / by William H. Dickinson.

Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: On the pathology and treatment of albuminuria / by William H. Dickinson. 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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    Fiff. 2. Casts of Tubal Nephritis. All the casts represented were obtained from patients in whom the nature of the disease was placed beyond doubt, either by post-mortem examination or by the fact of recovery having taken place. Most contain epithelial colls ; some, granular matter. Some are simple cylinders of iibrine. One bears evidence of having had a double origin, as explained in page 17, a large cast including others in its interior. (See p. 42.) PLATE IV., to face page 96. A pair of Kidneys affected by Granular Degeneration. They are of unequal size. The larger has had the capsule removed, so as to display the regular arrangement of granulations beneath. The smaller, which has the capsule partly removed, shows a number of cysts projecting from the surface. As not unfrequently happens, the contracting process has gone on unequally in the two kidneys, giving rise to the greater number of cysts where, the shrinking has been the most. The outsides only have been shown, since it is by the state of the surface that granular degeneration is chiefly characterised. Had the organs been shown in section, the most noticeable fact woidd have been dimi- nution of the cortical substance. The kidneys represented were taken from the body of a well-known jockey, who died at the age of forty-eight, having had albumimu-ia, dropsy, and obstinate vomiting, followed by coma. He had had gout. At the post-mortem examination the kidneys were in the condition depicted, with extreme shrinking of the cortices, evident on section. The left ventricle of the heart was hyper- trophied. The brain was ansemic and wet, and there was an incrustation of urate of soda upon the cartiLT,ges of the great toes. With these exceptions all the organs were natural. PLATE v., to face page 100. Fig. 1. Section of an advanced Granxilar Kidney, made by Mr. Lockhart Clarke's process (chromic acid, &c.). It shows an extensive intertubular growth of fibro-nucleated tissue, which is most abimdant in the neighbourhood of the capsule, a portion of which is seen along the upper edge. The surface is depressed opposite to the new formation. AVithin the larger mass of new tissue two blood vessels are seen. The malpighian bodies are enlarged. The tubes are generally empty. The kidney from which the section was cut was obtained from the body o± a man fifty years of age, who had long been subject to gout. Latterly he had had dropsy, the urine being scanty, albuminous, and containing dark granular casts. He died suddenly, having had vomiting, rigors, and faintness. The lungs ^vere foimd to be highly congested, and there was an extensive coagiilum in the piilmonary artery, which apparently had been the immediate cause of death. There was valvular disease of the heart, the mitral valve being dotted with m-ate of soda. The kidneys were greatly contracted, the pair weighing only 51 oz. The surfaces were highly granidar, and sliowed numerous cysts. Urate of soda was seen in the renal tissue.