The value of tests for renal function in early and advanced Bright's disease / by R. Fitz, M.D., Boston, Massachusetts.

  • Fitz, Reginald, 1885-1953
Date:
[1914?]
Catalogue details

Licence: In copyright

Credit: The value of tests for renal function in early and advanced Bright's disease / by R. Fitz, M.D., Boston, Massachusetts. Source: Wellcome Collection.

    3/18
    Extracted from the American Journal of the Medical Sciences, September, 1914, No. 3, vol. cxlviii, p. 330. THE VALUE OF TESTS FOR RENAL FUNCTION IN EARLY AND ADVANCED BRIGHT’S DISEASE.1 By R. Fitz, M.D., BOSTON, MASSACHUSETTS. (From the Medical Clinic of the Peter Bent Brigham Hospital, Boston, Mass.) Since Richard Bright2 described characteristic anatomical changes in various forms of kidney disease the problem of nephritis has occupied the attention of many observers. It is admitted that there are several types of nephritis, each one showing a different clinical course and different pathological lesions. It has been generally recognized that in the course of a nephritis, symptoms referable to toxemia have developed which have been given the inclusive name of “uremia,” and that nephritic patients have died of uremia, of cardiac failure, or of some intercurrent cause. But it has been found impossible to predict in an individual case by clinical study alone what course the disease will take in its development or what anatomical changes will be found at autopsy. Therefore, during recent years, methods have been devised for estimating renal function in order to make possible an early diag¬ nosis of existent kidney disease and to offer information in regard to its prognosis and treatment. In 1881 Fleischer3 followed the excretion of nitrogen, sodium chloride, and phosphoric acid in a series of nephritic cases. His patients were given a known diet, and were controlled by normal individuals with similar food. Fleischer found that the excretion of nitrogen in ratio to its intake in the pathological cases showed considerable variation, that phosphoric acid was poorly excreted, while the chloride balance was nearly perfect. These observations justify the assumption that in a diseased kidney, different parts show selective excretory functions tending to retain certain sub¬ stances from the diet and to excrete others normally. * In 1910 Schlayer4 and his co-workers began a series of experi¬ mental and clinical studies which have been of great value in the 1 Read before the Section in Medicine of the New York Academy of Medicine, March 5, 1914. 2 Guy’s Hosp. Rep., 1836, i, 358. 3 Deutsch. Arch. f. klin. Med., 1881, xxiv, 129. 4 Schlayer and Takayasu, Deutsch. Arch. f. klin. Med., 1910, xcviii, 17; Ibid., 1911, ci, 333; Ibid., 1911, cii, 311; Verh. des. Cong. f. innere Med., 1912, xxix, 501; Beihefte zur med. Klin., 1912, ix, 211; Munch, med. Woch., 1913, lx, 800.