Selected monographs.

Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

    102/440 (page 86)
    may easily be supposed that but little albumen is allowed to escape abnormally into the secretion, for there is always the basement membrane to be traversed, and more than this, the epithelial cells do not all at once completely lose their functions. The secretion of the liver would furnish the desired analogy, but, unfortunately, we have no definite inves- tigations with regard to its condition. Many years ago two- statements were made, from which, if they were sufl&ciently minute, we could conclude that albumen is really found in the secretion when the glandular epithelium is in a state of fatty degeneration. Thus Thenard states that he found albumen in the bile in five out of six cases of fatty liver,'' and Lehmann makes the same statement with regard to two cases of fatty granular liver (74). But even without these statements, what we have previously adduced definitely proves that albuminuria occurs in fatty degeneration of the renal epithelium following phosphorus-poisoning, and this latter should certainly no longer be adduced as evidence against the dependence of albuminuria upon fatty degenera- tion of the epithelium, for it is evidence of an opposite character. It is not denied that other factors may co- operate in the production of albuminuria in cases of phos- phorus-poisoning. Almost equally indefensible is the statement that the absence of albuminuria in various conditions of anaemia is evi- dence against the connection of the former symptom with fatty degeneration of the epithelium. It is certainly true that no albumen can be found in the urine in many cases of anasmia, but it is also indisputable that fatty degeneration of the renal epithelium does not accompany every form of ana3mia, even when of a very severe type—I need only refer to chlo- rosis. There are in particular certain pernicious forms of anaemia which lead to fatty degeneration, but the insignifi- cant amount of albumen excreted in these cases has caused its appearance to be disregarded. But albuminuria though trifling is a real symptom, and as deserving of notice as the albuminuria of congestion, which is likewise trifling as a general rule. The amount of significance to be attached to- the absence of albuminuria in pernicious ana)mia is ?hown by the single circumstance that, while from the stand-