Diseases of the kidneys and of the spleen, hemorrhagic diseases / by H. Senator and M. Litten ; edited, with additions by James B. Herrick ; authorized translation from the German, under the editorial supervison of Alfred Stengel.

  • Senator, H. (Hermann), 1834-1911.
Date:
1905
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the kidneys and of the spleen, hemorrhagic diseases / by H. Senator and M. Litten ; edited, with additions by James B. Herrick ; authorized translation from the German, under the editorial supervison of Alfred Stengel. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    diabetes, and so on. In these conditions also, parenchymatous—that is, epithelial—changes have sometimes been found ; but it has never been satisfactorily determined whether they are to be regarded as a sufficient cause for the albuminuria, as the pathologic condition of the blood and the circulatory disturbance which are so frequent may in themselves explain the albuminuria; and finally the influence of the nervous sys- tem, especially in diabetes, since CI, Bernard produced albuminuria by trephining, must also be taken into account. As regards diabetes mellitus in particular, it is stated by R. Schmitz ^ that albuminuria frequently occurs in this disease after the inordinate indulgence in raw or boiled eggs, and disappears again when the excessive ingestion of eggs ceases. According to the writer's own observations, which extend over a number of years, albuminuria occurring in the course of diabetes mellitus is not infrequently due to an insidious nephritis or to sclerosis of the kidneys. (See Chronic Indurative Nephritis, pp. 259—300.) 3. Albuminuria occurring in non-febrile diseases of the nervous system. In various pathologic conditions of the nervous system, such as epilepsy, ■ delirium tremens, various psychoses, cerebral apoplexy, nervous exhaustion, migraine, and Basedow's disease, transient albuminuria (or albumosuria), with or without hyaline casts, and sometimes the latter alone, have been noted by a large number of observers, M. Huppert, de Witt, v. Rabe- nau, Kleudgen, Fiirstner, Koppen, Vassale and Chiozzi,^ Voisin and Peron. This category does not, of course, include chronic renal dis- eases, which may coexist with the above-mentioned conditions or may be attended by similar manifestations (uremia), nor does it include dysp- nea or passive congestion occurring as the result of convulsions. The cases outside of this category are explained by assuming a special influ- ence on the part of the nervous system, either a direct influence on the part of the medulla oblongata, as suggested by CI. Bernard's albumin- uria after puncture, or an indirect influence through changes in the cir- culatory conditions. The transient albuminuria that sometimes occurs in normal individuals after psychic emotion (p. 32) possibly represents a transitional form between the physiologic albuminuria and the form here under discussion. Such an albuminuria has a certain diagnostic influence when there is a suspicion of simulated convulsions or mania. 4. Albuminuria in affections of the intestinal tract, without demon- strable primary disease of the kidneys. Englisch ^ and Frank * find albumin in the urine in about two-thirds of a series of cases of intesti- nal obstruction from kinking of the bowel, the quantity being, generally speaking, proportionate to the severity of the disease. As the intestine becomes permeable, either by the removal of the obstruction or by the development of gangrene, the albuminuria diminishes. The urine is scanty, and contains in addition to albumin, hyaline or granular casts. 1 Berlm. Bin. Woch., 1891, No. 15. ' Chiozzi, La, Rifornia med., 1891, No. 249. The rest of the literature is given by Goldstein, he. cit., p. 393. =* Oesterr. med. Jahrb., 1884, Nos. 2 and 3. * Berlvn. klin. Woch., 1887, No. 38,