Lectures on auto-intoxication in disease, or, Self-poisoning of the individual / by Ch. Bouchard ; translated, with a preface, by Thomas Oliver.

Date:
1894
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Licence: Public Domain Mark

Credit: Lectures on auto-intoxication in disease, or, Self-poisoning of the individual / by Ch. Bouchard ; translated, with a preface, by Thomas Oliver. 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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    LECTURE XY. The Therapeutic Pathogenesis of Uraemia. assume of the pathogenesis of uraemia considered as a complex intoxication and due to poisons resulting from disassimilation, furnished by alimentation, the biliary secretions, and intestinal putrefactions. The renal emunction, having become insufficient, may be supplemented by other apparatus,—the skin and lung ? Baths of hot and dry air ; vapor baths. Sudorific medica- ments. These methods have the fault of diminishing the renal secretion. Means destined to arouse the renal function, either by reducing congestion of the kidneys (revulsives, cupping, sinapisms) or by accelerating refiexly the renal circulation (utility of dry cutaneous friction). Action of medicaments called diuretics (caifeine, digitalis). Indications, counter-indications, and management of digitalis in nephritis. Cold injections as a diuretic; cool drinks. Urea as a diuretic medicine. Can we supplement the kidney by utilizing, as an emunctory, the mucous membranes of the digestive canal ? Vomitings : their inconveniences. Purgatives : the dehydration of the tissues which they produce may become dangerous. Of bleeding: it removes from the blood one-sixteenth of the extractive material which the urine ought to throw out. A bleeding of 32 grammes removes as much poison as 280 grammes of diarrhoeic liquid, and as 100 litres of perspiration. Utility of bleeding supported by clinical experience. Its formal indication in acute curable nephritis. Its employment owing to its being the best and a rapid expedient in the terminal uraemia of chronic nephritis. Antidotes to uraemic poisons. Inhalations of chloroform. Action of chloral. Bromide of sodium. Traditional and pathogenic therapeutics. Milk regimen to diminish biliary secretion and to prevent putrescible intestinal residues. Charcoal as the means for fixing the coloring matter of the bile. Interdic- tion of roast meat, aliments rich in extractive and mineral matter, soup. Diet composed of milk, white of egg, cheese, boiled meat. Disinfection and intestinal antisepsis with iodoformized charcoal and naphthalin. Agree- ment between the means which experiment has ratified and those which are the outcome of a study of pathogenesis. I REGARD uraemia, then, as a complex poison, to which, in unequal proportions, all the poisons introduced normally into the organism or found therein physiologicall}^ contribute, when the quantity of poison formed or introduced in twenty-four hours can no longer be eliminated in the same time by the kidneys, which have become scarcely sufficiently permeable. This view, the legitimacy of which, I think, I have experimentally demon- strated to you, differs, to a certainty, from the old doctrines and