Volume 2

Clinical diagnosis : case examination and the analysis of symptoms / by Alfred Martinet.

  • Martinet, Alfred, 1868-1922.
Date:
1922
Catalogue details

Licence: In copyright

Credit: Clinical diagnosis : case examination and the analysis of symptoms / by Alfred Martinet. Source: Wellcome Collection.

    22/772 (page 650)
    ACUTE FORMS OF ALBUMINURIA. Acute albuminuria is met with almost exclusively in the following four groups of cases : (a) Superficial and transitory acute nephritis; (b) typical acute nephritis; (c) hyperacute nephritis; (d) acute exacerbation in. the course of a chronic nephritis. (a) Superficial and transitory acute nephritis is a clinical type which is mild and very common and the presence of which should b.e ascertained through systematic examination of the urine in all infectious or toxic diseases (sore throat, grippe, pneu¬ monia, acute gastric indigestion, enterocolitis, etc.). The albuminuria is the constant sign of such a nephritis; in degree it generally ranges between 0.1 and 0.5 gram of albumin pe.r liter of urine, but it may become more pronounced. It persists throughout the fastigium of the infectious or toxic dis¬ order, but as a rule passes off shortly before the beginning of convalescence. It is clinically limited to a moderate and transi¬ tory albuminuria, accompanied by very slight, temporary dis¬ turbance of the renal functions, erythrocytes, leucocytes, and granular casts appearing for a time in the sediment. Complete and permanent recovery from it is the rule, though the physi¬ cian should be somewhat guarded* concerning the passage of these cases of nephritis into a chronic involvement, which is, however, exceptional. (b) Typical acute nephritis is met with under the same con¬ ditions as the preceding group, i.e., generally in connection with and during the course of an acute infection, definite or obscure. It is characterized by three cardinal groups of signs by which it may easily be recognized, and the following summary of which is adapted from Castaigne. 1. The urinary syndrome, which may be summarized as follows : The urine is scanty, highly colored, comparable to turbid bouillon, sometime's reddish, and even occasionally ex¬ hibiting hematuria. The specific gravity is high, and the re¬ action distinctly acid; chemical examination generally reveals a marked diminution of the urea and chlorides, together with a large amount of albumin. Histologic examination of the urinary sediment show's the presence of red blood cells, leuco-