The morbid effects of the retention in the blood of the elements of the urinary secretion / by William Wallace Morland.

  • Morland, W. W. (William Wallace), 1818-1876.
Date:
1861
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Licence: Public Domain Mark

Credit: The morbid effects of the retention in the blood of the elements of the urinary secretion / by William Wallace Morland. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    acid vicariously depurates the liver from any excess of carbon. (Bird.) Supposing this to be true, and renal disease to supervene under these circumstances, the most disastrous results would seem to be unavoidable. There is no symptom or set of symptoms, so far as we are aware, which would indubitably indicate an excess of hippuric acid in the blood ; and the manifestations which we have enumerated, occurring as directly antecedent phenomena to the detection of such an excess, and seemingly dependent upon it, are only to be taken as probably the explanation thereof. It is, at least, reasonable to conclude, as we previously remarked, that when the acid appears, more or less suddeuly, in excess in the urine, it has been equally so in the blood, and for a longer or shorter time—the period, possibly, being indicated more or less distinctly by certain morbid signs. Dr. Golding Bird closes his remarks upon the Pathology of Hippuric Acid in the following terms : My own experience in these cases has been too limited to justify my offering any opinion on the pathological complications attending them. From what little I have observed, I feel inclined to believe that when an excess of hippuric acid exists, it may always be regarded as traceable to, or pathognomonic of, the deficient function of the liver, lungs, or skin, the great emunctories of carbon ; or to the use of food deficient in nitrogen. It hence follows, that our treatment will consist in appealing to the function at fault, and carefully regulating the diet. I would suggest the propriety of seeking for the presence of hippuric acid in the urine, where it is copious, of low specific gravity, but slightly acid or neutral, and occurring in persons who have a dry and inactive state of surface, with anaemia. In many pseudo-chlorotic cases in both sexes, I am inclined to believe an abnormal proportion of this acid will often be met with. (Op. cit., p. 213.) Dr. Thudichum refers to the discovery, by Lehmann, of hippuric acid in diabetic urine, whenever he had sought for it; and also in the acid urine of fever-patients, of which it is said to cause, in part at least, the acid reaction. Hiinefeld and Duchek confirmed the experiments of Lehmann. Schlossberger found hippuric acid in the scales of ichthyosis. Whether this was only an isolated instance, or whether it is of frequent or constant occurrence in that disease, is not stated. (Auct. ante cit.) Many observations are needed before we can attain to any more precise knowledge of the pathology of hippuric acid. The subject is yet in that undeveloped state which induced Dr. Thudichum to conclude his chapter upon it in these words : The reader will think this a very unsatisfactory chapter, and so indeed it is. We want observations, for which there is a large field open. But undoubtedly some technical difficulties will have to be overcome first, before the analysis of hippuric acid can be made with sufficient accuracy. (Op. cit., p. 152.) This author has recently investi- gated the subject in its chemical, physiological, and pathological relations; and if he finds the stores of information in regard to it so meagre, and if