Atrophy of the suprarenal capsules with enlarged spleen and dark-coloured urine / by Robert Saundby.

  • Saundby Robert, 1849-1918.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Atrophy of the suprarenal capsules with enlarged spleen and dark-coloured urine / by Robert Saundby. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    Reprinted from ‘ Transactions of the Pathological Society of London* for 1885. Atrophy of the suprarenal capsules with enlarged spleen and dark-coloured urine. ^ By Egbert Satjndby, M.D. CVn November 24t]i, 1879,1 was asked to see W. H. E—, aged 16. He complained of cough and pain in the left side; he had be«|i ill two days. Pulse 120; respirations 18 ; temperature 102°. Percussion showed about two fingers’ breadth of diminished re- sonance at the left base posteriorly ; respiratory sounds everywhere slightly harsh; inspiration prolonged. The heart’s apex was in the fourth interspace, three inches and a quarter to the left of the middle line just inside the nipple ; there was a systolic murmur at the base propagated into the neck and a loud hruii de diahle in the jugulars. In the left hypochrondrium there was a large tumour which reached across to beyond the middle line of the abdomen; its inner border was rounded, tense, and presented a well-defined notch ; there was much tenderness in this region. No enlargement of the liver was detected. The bowels had not been moved for three days. There was great difiiculty in micturition, which could be effected only in the “ knee-and-elbow ” position, apparently on account of the enormous splenic tumour. The urine was porter- coloured and deposited brown flocculent matter which was com- posed of urates, oxalates, blood-casts and material resembling broken-down blood-corpuscles. It was acid, sp. gr. 1017, and con- tained a considerable quantity of albumen, but no sugar or bile. Dr. MacMunn, of Wolverhampton, examined it for me with the spectroscope, and reported that the colour was due to methsemo- globin and urobilin. The blood examined under the microscope showed only a very slight excess of leucocytes. His skin was a peculiar dusky yellow, but the conjunctivae were quite white. His mother informed me that he had “ always passed dark urine from his birth, that the enlargement of the spleen had been known to exist for some years, that his father died at the age of thirty-seven with the same symptoms, viz, enlargement of the spleen (which weighed 7^ lbs. on post-mortem examination), dusky skin and dark urine, and that the younger of two other living children, both girls, passed the same peculiar coloured urine, though she was otherwise well and strong.”