The relations of cardiac hypertrophy to renal disease / by Robert Saundby.

  • Saundby, Robert, 1849-1918.
Date:
[1880]
Catalogue details

Licence: Public Domain Mark

Credit: The relations of cardiac hypertrophy to renal disease / by Robert Saundby. Source: Wellcome Collection.

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    although in recent times it received the support of so eminent an authority as Bartels. The next original explanation was that given by Dr. George Johnson, which has undergone at least two modifications. In the first place Dr. Johnson pointed out the excessive thickening of the muscular walls of the renal arterioles, and suggested that the obstruction to the circulation offered by a state of tonic spasm in these vessels, would explain their own alterations, the rise of blood pressure and the cardiac hypertrophy. But having been able to discover similar changes in the vessels of the pia mater and mesentery, he enlarged his hypothesis and imagined a state of tonic spasm of the whole systemic arterioles which he attributed at first to direct irritation by the impure blood, and later on to stimulation of the vaso-motor centre. According to his present views he regards the condition as analogous to asphyxia, in which unoxygenated blood going to the brain stimulates the vaso-motor centre in the medulla, and causes contraction of the arterioles throughout the body with consequent increase of the arterial blood pressure. The great objection to this theory of general constriction of the vascular system is that, under such circumstances, the urinary secretion would be diminished or suppressed, as indeed occurs in asphyxia ; whereas, in granular kidney, as is well known, the rise in blood pressure is accompanied by an increase in the flow of urine. Moreover, Grutzner (Pfluger’s Archiv Bd. xi., s. 370) has shown that the diuresis excited by the intravascular injection of salts such as nitrate of potash is arrested during suspension of the respiration, unless the nerves to the kidney are divided. This failure in the analogy has always appeared to us a very weak point in the theory, but recently further light