Studies of nitrogen partition in the blood and spinal fluid, with especial reference to the possible causation of albuminuric retinitis / Alan C. Woods, M.D. Boston.

  • Woods, Alan C. (Alan Churchill), 1889-1963
Date:
1915
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Licence: In copyright

Credit: Studies of nitrogen partition in the blood and spinal fluid, with especial reference to the possible causation of albuminuric retinitis / Alan C. Woods, M.D. Boston. Source: Wellcome Collection.

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    AND SPINAL FLUID WITH ESPECIAL REFERENCE TO THE POSSIBLE CAUSATION OF ALBUMINURIC RETINITIS * ALAN C. WOODS, M.D. BOSTON The fact that an albuminuric retinitis, occurring in the course of a chronic nephritis, is a sign of the gravest prognostic import, has long been recognized. Within the last five years, this has been the subject of considerable investigation, especially by the French clinicians, and •several very interesting theories have been advanced. Chauffard* 1 attempted to explain albuminuric retinitis on the grounds of a hyper- cholesterinemia, while Onfrey and Balavoine2 attempted to show that changes in the viscosity of the blood played an important part. The theory that attracted the greatest amount of attention, however, was that advanced by Widal3 in 1910. He stated that albuminuric retinitis was the result of the retention in the blood of urea, or of some nitrog¬ enous body closely allied to urea. In 1912 Widal4 reviewed the work of Chauffard and agreed with him that cholesterin, lipoids, and lecithin compounds might often be retained in the blood in nephritis. Widal found, however, that this retention fell as the urea retention rose and stated that retinitis occurred only in those cases which showed a definite nitrogen retention. The prognostic significance of albuminuric retinitis was due, therefore, he believed, to the fact that it stood as a sign of nitrogen retention. The. object of my work has been to determine whether such a rela¬ tion between nitrogen retention and the occurrence of albuminuric retinitis could be demonstrated, and whether or not albuminuric retinitis could be charged to “urea or to any closely allied nitrogenous body.” Using the newer methods, estimations were made of the total non¬ protein nitrogen, of the ammonia nitrogen, of the urea nitrogen, the * From the Medical Clinic of the Peter Bent Brigham Hospital. 1. Chauffard: Pathogenie des retinites albuminuriques, Semaine med., 1912, xxxii, 193. 2. Onfrey and Balavoine: Viscosite du sang et hemorragies oculaires, Ann. d’ocul., 1911, cxlvi, 433. 3. Widal, Morax and Weill: Retinite Albuminurique et Azotemie, Ann. d’ocul., 1910, cxliii, 354. 4. Widal, Weill and Landat: La lipemie des brightiques; rapports de la retinite des brightiques avec l’azotemie et la cholesterinemie, Semaine med.,