Urinary and renal derangements and calculous disorders : hints on diagnosis and treatment / by Lionel S. Beale.

  • Beale, Lionel S. (Lionel Smith), 1828-1906.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Urinary and renal derangements and calculous disorders : hints on diagnosis and treatment / by Lionel S. Beale. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    that the subject could not be treated of in a volume consisting of many more hundred pages than the present contains. I shall only attempt to direct the attention of practitioners to the management of those derangements and diseases of the urinary system which frequently fall to the province of the physician to treat. In many cases I can only give hints as to the general line of treatment to be pursued, but as regards some conditions, I hope to offer suggestions based on facts I have observed, or learnt from others, in the course of more than thirty years’ practice, which may be useful to the practitioner. I shall not attempt even to enumerate all the remedial measures which have been proposed or carried into effect, but endeavour rather to concentrate attention upon the principles which should guide us in the treatment of the various departures from the healthy state, of which indications are afforded by examining the urine, or by other methods of clinical observation. Nor is it only in great alterations in the amount of its usual con- stituents that the urine of health may differ from that secreted in physiological derangements or in structural disease. There are several substances which may be present, of which not a trace can be detected in the secretion in health—biliary, albuminous, and other matters from the blood, sugar—besides many things forming definite and perhaps bulky deposits, of which mere traces, or no indications whatever, exist in the urine in the healthy condition, may be present, and in varying quantity. Of these, some indicate a condition of things which may be expected to end fatally within a short period of time, while others are due only to a transitory disturbance, a temporary and unusual chemical change, or are accidentally present. The practitioner has to bear in mind the dis- tinguishing general features and chemical microscopical characters by which substances which are of great significance may be identified and distinguished from those which are of no clinical consequence. VARIATION IN THE QUANTITY OF WATER.—IMPORTANCE OF DILUTING THE FLUIDS OF THE BODY, AND OF WASHING OUT THE TISSUES. All the liquid secretions of the body vary from time to time as regards the proportion of water by which the special constituents are held in solution, but in this respect the urine varies more than any other secretion. At one time the proportion of solid matter to water may be as i to io, at another as i to 1,000. Although the quantity of water in the urine is determined mainly by the amount taken, it does not wholly depend upon this circumstance, neither does it vary in direct ratio with the water imbibed, for in hot weather, though an excessive amount of water be taken, the urine will be found highly concentrated, the water removed from the cutaneous surface preponderating over the quantity passing through the renal emunctories.