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

  • Dickinson, W. Howship (William Howship), 1832-1913.
Date:
1877
Catalogue details

Licence: Public Domain Mark

Credit: On the pathology and treatment of albuminuria / by William H. Dickinson. Source: Wellcome Collection.

    40/476 (page 16)
    From rciml changes. Result of transuda¬ tion from blood¬ vessels. Depending on conges¬ tion. 16 ALBUMINURIA. Chap. II. must be rare. Other morbid conditions occasionally pre¬ sent themselves, especially some exceptional forms of hepatic disease, in which it seems that in consequence of the abeyance of hepatic action an undue amount of albu¬ men reaches the blood without hepatic transformation, only to be cast out by the kidneys. It is not now my purpose to discuss albuminuria save as a symptom of renal disease. Alimentary albuminuria is practically un¬ known save as the result of experiment; and what may be termed hepatic albuminuria, which appears cliiefty to belong to acute atrophy, is, like that disease, of very infre¬ quent occurrence. With this exception, it may be stated as a rule that when the urine contains albumen the kid¬ neys are abnormal either in circulation or in structure. Albumen is a colloid body which transudes with difficulty; its passage through the apparatus of renal dialysis may be generally accepted as an indication that the machine is mechanically imperfect, or is working under unusual pressure. The urine is albuminous because it is mixed with se¬ rum, or at least with its albuminous constituent, which has passed from the blood-vessels into the urinary ducts. There are three conditions, mainly, which are associated with this unnatural leakage. Two relate to the blood¬ vessels, one to the tubes :— I. Congestion : undue pressure within the vessels sup¬ plying the glandular structures. II. Lardaceous change in blood and vessels, which is ac¬ companied by transudation of liquor sanguinis. III. A loss by the secreting tubes of their epithelial lin¬ ing, in consequence of which they readily yield passage to fluids which otherwise could not tra¬ verse them unaltered. 1. Taking these conditions one by one, congestion is shown to be a cause of albuminuria both by the observa¬ tion of disease and by experiments upon animals. The