Bright's disease of the kidney / by Alfred L. Loomis.

  • Loomis Alfred L. (Alfred Lebbeus), 1831-1895.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Bright's disease of the kidney / by Alfred L. Loomis. 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.

    17/128 (page 11)
    functions in renal failure. Nor can those assumed clinical evidences of the excretion of urea by the intestinal canal, nausea, vomiting, and diarrhoea, be relied upon as accurate indications of the amount of vicarious action going on in any given case. Even carefully conducted experiments for determining the amount thus eliminated, as well as that thrown off by the skin, leave much to be desired. It must be admitted, on the other hand, that many cases occur in which a large accumulation of urea in the blood is not attended by uraemic symp- toms, and that such phenomena are developed in cases where the amount of urea in the circulation is but slightly if at all increased. Such facts have led vari- ous observers to consider some other single element as the materies morbi. Traube advanced the theory that the “uraemic ” phenomena were due to mechani- cal effects of cerebral cedema and an anaemia, which was due partly to compression of the cerebral tis- sues and in part to diminution of the corpuscular elements of the blood, in varying proportions. In many cases of uraemia, however, the brain is shown to be abnormally dry, while in other cases the cedema has been shown to be secondary to the uraemic attack, rather than its cause, or the result of decrease in cerebral tissue from atrophic changes. The latter, of course, only in chronic cases. Minute capillary haemorrhages have not infre- quently been found in cases of uraemia, and when