The morbid effects of the retention in the blood of the elements of the urinary secretion / by William Wallace Morland.

  • Morland, W. W. (William Wallace), 1818-1876.
Date:
1861
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Licence: Public Domain Mark

Credit: The morbid effects of the retention in the blood of the elements of the urinary secretion / by William Wallace Morland. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    B right's disease, and considers it may be explained by the action of the poisonous material retained in the blood, and seeking a vent through sup- plementary channels of excretion.1 He then refers, as corroborative proof, to the post-mortem appearances observed in these cases; most commonly evident traces of disease are met with in various organs besides the kid- neys. This distinguished observer adds, that these manifestations prevail with irregular frequency in different places. They are probably determined, in some measure, by local and peculiar agencies. Thus, vomiting and diar- rhoea have been more familiar to the Edinburgh observers, than in London to Dr. Bright, or in Paris to M. Solon; while the headaches and coma so often witnessed by the British physicians have been comparatively uncom- mon in France.8 Although, in abnormal retention of urea in the blood, the vital tissues and fluids are all more or less affected, and, by a concomitant disturbance of the watery as well as of the solid portions, dropsical effusion may arise, yet the spinal cord and brain are the organs chiefly affected whenever urea becomes a blood-poison; and we have seen that the instances where it is not thus morbidly efficient, when retained in the blood, are exceptional. Generally speaking, when the amount of urea thus traversing the system is considerable, its effects are decided and rapidly disastrous. The affection is, properly, a cachectic condition; in other words, the system is, throughout, evidently depressed by a poison.3 Were it not, moreover, that the disease of the cerebro-spinal system, consequent on uraemia, is usually so severe, persistent, and fatal, the blood would become very seriously altered in its constituent parts, and finally devitalized, by the retention of urea; and, in addition, the whole play of the vascular system would be disturbed. The large quantities of albumen often eliminated during the retention of unusual amounts of urea in the blood cannot be said to be referable to the presence of urea alone. Albuminuria and uraemia may coexist, but the union is not a necessary one; neither is directly causative of the other. This fact we find pertinently referred to by Prof. Gr. S. Bedford, in his short but instructive chapter on uraemia.* 1 M. Claude Bernard (Lecons sur les Proprietes Physiologiques et les Alterations Pathologiques des Liquides de l'Orgairisme. Paris : J. B. Bailliere, 1859) remarks that in renal disease, when the urine is suppressed, intestinal disorder supervenes. The bowels have taken up, so far as they can, the elimination of urea. The rule is, that there is an elective affinity manifested by certain glands in the elimination of certain products from the blood. When anything interferes with their action, others fulfil their office to the best of their ability. 2 Lectures on the Principles and Practice of Physic, fourth edition, London, 1857, vol. ii. p. 682. 3 Notwithstanding that many of the cerebro-spinal phenomena observed are those of irritation or excitation. 4 Clinical Lectures on the Diseases of Women and Children.