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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    agency of chloride of sodium. Dr. Golding Bird remarks, in this connec- tion, that it would seem that this chloride, besides furnishing hydrochloric acid to the stomach, and soda to the bile, also exerts an important physio- logical influence in aiding the metamorphosis of tissue, and consequent depuration of the blood. (Op. cit., p. 127.) If we accept this as true, we not only need not ascribe any morbid effects to the retention of chlorine —or of chloride of sodium—in the blood, but rather deem its presence desirable and salutary—at all events, in the vast majority of cases. Certain of Hegar's conclusions, which were arrived at under the super- intendence of Liebig and Vogel (G. Bird), are interesting in this connec- tion. We select a few, in illustration :— The amount [of chlorine in the urine] varied in different individuals, depending partly on the food, and partly on habit of life and constitution. It was increased by exercise and copious draughts of water, which appeared to act by washing it out of the system, as the augmentation was only tem- porary. Indisposition diminished the quantity. In health, though no chlorides were taken with the food, they were always found, and must therefore have been obtained from the blood or tissues. When a larger quantity was taken than usual, the whole did not escape from the system by the kidneys, nor even the bowels. The latter two facts would seem to go far to prove the innocuousness of even considerable amounts of chlorine in the blood. Dr. Day (Contribu- tions to Urology) is quoted by Dr. Bird as testifying to the fact to which we have previously called attention ; that the chlorides are diminished in all cases of disease accompanied by copious exudation from the blood. We notice that Dr. Bird asserts, as from Dr. Beale, that the nature of the diet necessarily adopted in pneumonia and other acute diseases, seems insufficient to explain the absence of the chlorides from the urine. Doubt- less this default of ingestion of chlorine will not fully meet the require- ments of the case in the way of explanation, but it seems only reasonable to allow it no inconsiderable weight. The following are Dr. Beale's very important propositions :— 1. That chloride of sodium is totally absent from the urine of pneumonic patients at the period of complete hepatization of the lung. 2. The chloride reappears after the resolution of the inflammation. 3. The chloride exists in the blood in the largest quantity, when most abundant in the urine, and vice versa. [We may here, again, find reason for inferring the harmlessness of even large quantities of chloride of sodium in the blood ; for when it is considered that under these circumstances, were it easily, or at all, a cause of disease, the conditions for the development of morbid action abundantly exist, we certainly have sufficient ground for the above opinion.] 4. The chloride exists in very large quantity in the sputa of pneumonic patients. .>. There is reason to believe that in pneumonia the chloride is determined