A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology — John Shaqi
A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Science
A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Medicine -- Practice
A most interesting group of cases has been recorded by Weil,[10] where
out of a family of 91, 28 were polyuric. The head of the family, a
polyuric, lived to the age of eighty-three, while his descendants were
robust, many of them attaining a good old age. There were no anomalies
of the circulation, and the persons affected were not alcoholics. Their
only complaint was of a troublesome thirst, and they declined
treatment.
[Footnote 10: _Cbl. für die Med. Wiss._, 1884, p. 263, from _Virch.
Arch._, xcv.]
The PATHOLOGY of diabetes insipidus, so far as is positively known, may
be gathered from the previous account of its etiology and symptoms. It
is evidently of nervous origin in the great majority if not all cases.
It is often connected with distinct lesions of the nervous system, and
attended with other nervous symptoms. In some cases it occurs in
connection with a well-marked hysterical diathesis. The copious flow of
pale urine as a sequel to the hysterical paroxysm is well known, and
the same thing often attends a severe nervous headache in either sex.
It is probable that the polyuria attending lesions of the urinary
passages is a reflex nervous phenomenon, since it may be present when
there is no suspicion of organic renal disease.
Guyon[11] states that surgical polyuria occurs under three {32}
conditions--painful excitation of the sensibility of the deeper portion
of the urethra or the vesical mucous membrane; repeated attempts to
urinate during the night; retention of urine more or less complete, but
especially when there is distension of the bladder. Of the first cause
he gives an instance in the case of a young man who had a polyuria
whenever a bougie was passed beyond a urethral stricture.
[Footnote 11: _Leçons cliniques sur les Maladies des Voies urinaires_,
Paris, 1881.]
Where, however, polyuria, especially chronic, is due to habitual
over-distension, it is in the highest degree probable that it is at
least partly due to structural alteration of the kidney. The well-known
experiment of Bernard, by which an increased flow of urine was induced
by a puncture of the floor of the fourth ventricle, and those of
Eckhard on section of the splanchnic nerves, show how it is possible
for nervous affections to influence the secretion of urine, though the
path or paths of the influence are by no means completely made out.
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