A contribution to the study of some forms of albuminuria (nephritis) associated with kidney tension and their treatment / by Reginald Harrison.

  • Harrison, Reginald, 1837-1908.
Date:
1903
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Licence: In copyright

Credit: A contribution to the study of some forms of albuminuria (nephritis) associated with kidney tension and their treatment / by Reginald Harrison. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    almost any degree by a gradual force acting from within, as, for instance, the retrograde pressure proceeding from strictures which oppose the escape of its excretion, but from the nature of its structural constituents is incapable of adapting itself to sudden emergencies of this kind. Before proceeding to notice some results which have followed certain operations I have practised upon the kidney, and the deductions which these seemed to warrant, there are two questions I should like to raise. In the first place, is there evidence to warrant a conclusion that the exudation of albumin by the kidneys is the result of structural damage directly occasioned, as might occur as the result of nephritis or renal congestion ? And in the second place, are the degenerative changes subsequently noticed in the chronic forms of these affections consequent upon the damage thus inflicted on the organ ? Possibly my surgical experience has led me to exag^ gerate the disastrous effects of tension on the tissues of the body, though for the most part it has been gained in regions which may be said to be less highly organised and less delicate than the excreting apparatus of the kidney. It certainly seems somewhat remarkable at the present day that so many different views exist, or have been put forward, explanatory of the process by which albumin exudes so as to form a variable part of the urinary excretion. These various theories I shall not attempt to discuss in detail or to reconcile. That albumin is frequently found in the urine under conditions necessi- tating high vascular tension, and where the excretory strain on the organ is considerable, as in the acute form of scarlatinal nephritis, cannot, I think, be denied. Re- ferring to the latter point, Sir T. Grainger Stewart observes:1 “Albuminuria is very often due to changes of an inflammatory character in the epithelium of the tubules and in the stroma of the organ, and in a very large pro- portion of the cases in which it occurs in practice it is dependent upon this cause.” That the changes which take place as a consequence of nephritis by the substitution of a lower for a higher excretory tissue, as we see in the cirrhosed forms of Bright’s disease, are due to the damage the organs received in the active and initial stage of 1 Lectures on Albuminuria. 1888,