The causal lesions of puerperal convulsions : a paper read before the Pathological Society of Philadelphia, April 28th, 1878, and reprinted from their Transactions / by James Tyson.

  • Tyson, James, 1841-1919.
Date:
1879
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Licence: Public Domain Mark

Credit: The causal lesions of puerperal convulsions : a paper read before the Pathological Society of Philadelphia, April 28th, 1878, and reprinted from their Transactions / by James Tyson. 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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    Edinburgh, and is well known to the profession as Braun on the Ursemic Convulsions of Pregnancy, Parturition, and Child-Bed. In this volume he says, The coincidence of eclampsia and albuminuria is an undisputed fact, which is verified by the very numerous observations of Lever, Simpson, Devilliers, Kegnault, Dubois, Danyau, Cazeaux, Cor- mack, Blot, Helft, Frerichs, Litzmann, the author, and many others, as also by daily observations. This has opened a new path to the knowledge and treatment of this most dangerous disease, so that the eclamptic con- vulsions of women during pregnancy must be considered to be identical with the fits of adults in general that are produced by uraemia in the course of acute Bright's disease. This I publicly declared in January, 1851, and at the same time Frerichs published his most convincing classi- cal treatise on the subject. It must now be considered an axiom in theory as well as in practice. Braun proceeds to prove his proposition by a long argument, from which I abstract only such as is based upon post-mortem examinations or the presence of albumen in the urine. Of forty-five cases published by him, fifteen died, but post-mortem examinations were made only in twelve. In seven of these Bright's disease was proven to be present by microscopic examinations, made by Wedl and others. In all the remaining cases the kidneys were hyperstmic ; but from accidental obstacles no microscopic ex- amination was made. But, as he says, this cannot be considered any proof of the absence of Bright's renal exudation. On the other hand, the hyperemia would seem to afford presumptive evidence of the presence of Bright's disease. Gustav Braun further communicated to him six cases with fatal termination, in three of which Bright's disease was demonstrated beyond a doubt. He further alludes to one case published by Lumpe, two by Hecker, four by Devilliers and Begnault, three by Simpson, two each by Sabatier and Hohl, one by Blot, Cohen, Wieger, Litzmann, and Crede, in all of which were found Bright's disease of the kidney after death. Hasse never saw eclampsia puerperalis without Bright's disease. Braun concludes with the statement, There are above thirty cases known to me offering positive proofs of the intimate connection between Bright's disease and eclampsia, and they are far too numerous to admit of the opinion that there is only an accidental connection between the two being still entertained. Their value as arguments is very much enhanced by the circumstance, that in negative observations the histology of the kidneys was examined microscopically only in very rare instances. He further states that in an observation by Oppolzer and himself, they prognosticated the outbreak of eclampsia two days before its occurrence