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

  • Robert Saundby
Date:
[1880]
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Licence: Public Domain Mark

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

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    in dilated vessels so that the normal calibre is only excep¬ tionally reduced. But in addition we have the fact that in a considerable proportion of cases of granular kidney cardiac hypertrophy is found unaccompanied by the vascular changes. According to Ewald* this occurred in 4 out of 20 cases, and we have been able to confirm the statement in about the same proportion of cases (2 out 10). Finally in chronic parenchymatous nephritis the occurrence of cardiac hypertrophy is not infrequent, but the vascular changes are quite exceptional. Therefore, although there is much in the view taken of Bright’s disease by these authors with which we cordially agree, we must regard their explanation of the cardiac hypertrophy as failing to square with all the facts of the case. The latest explanation we owe to v. Buhl.f He believes the cardiac and renal changes proceed pari passu, the hypertrophy is to be attributed to the self- increased activity (Selbsteigene Thatigkeit) of the heart. Myocarditis occurs very early, which may cause no alteration, or atrophy oq hypertrophy of the organ. Most frequently it causes hypertrophy. As the in¬ flammatory process comes to an end the cardiac muscle hypertrophies from excess of nutrition, and to overcome the increased work of the dilated ventricle. In addition he regards the fact as ‘quite new,’ that a relative stenosis of the aorta is present. The rise of blood pressure in the aortic system is due to the hypertrophy of the ventricle and the narrowing of the aorta. The relative frequency of myocarditis in renal disease is an undoubted fact, and this process plays an important * Ueber die Verauderungen kleiner Gefasse bei Morbus Brightii und die darauf Bezuglichlen Theorien. Virchow’s Archiv Bd. lxxi.* Heft 4. f Ueber Bright’s Granularschwund der Nieren und die darnit zusammen- hangende Herzhypertrophie. Mittheilungen aus dem pathol. Institut zu Munchen, 1878. S. 38.
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