Systematic case-taking / by Henry Lawrence McKisack.

  • McKisack, Henry Lawrence.
Date:
1912
Catalogue details

Licence: In copyright

Credit: Systematic case-taking / by Henry Lawrence McKisack. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    albuminous material, to which have been added a variety of substances giving the respective characters to the casts. The following varieties may be enumer- ated ; Hyaline casts: clear, semitransparent. Epi- thelial casts; more or less completely composed of epi- thelial cells. If studded with granules, the detritus of broken-up cells, they are granular casts. These granules may be largely composed of fat droplets, which, if abun- dant, give their name to fatty casts. Blood casts have a number of red corpuscles incorporated in them. If the cells are white corpuscles, the casts are termed leucocytic casts. Waxy casts are probably epithelial or hyaline casts which have undergone degeneration owing to their retention in the tubules for a considerable time. They are broad, pale, often yellowish, and highly refractive, with sharp outline. Casts are almost invariably an indication of disease of the kidneys, the chief exception being the fact that hyaline and occasionally granular casts are sometimes found in the urine of cases of jaundice, where the kidney is not apparently affected ; also, hyaline casts may be found in some cases of fimctional albuminuria. Any or all of the varieties of casts named may be found in cases of nephritis, but by observing which type occurs most frequently in any case some help may be gained in the diagnosis. Thus, blood casts are common in acute nephritis, and at times in chronic nephritis. Epithelial, granular, and fatty casts are characteristic of tubal nephritis, and are less often seen in the con- tracted forms (small white and small red kidney). Waxy casts are not often found in cases of amyloid kidney, but are an evidence of chronicity. Hyaline casts are of little or no diagnostic value. Epithelial cells of many forms may be found in the 8