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
Low specific gravities are the rule in diabetes insipidus and with
acute and chronic diffuse nephritis. In chronic diffuse nephritis the
specific gravity remains low even if the quantity of urine passed is
very small. When there is almost suppression of urine from occlusion of
the ureters the urine that is passed is of low specific gravity.
These changes in specific gravity correspond of course to the amount of
solid matter in solution in the urine, and may depend upon a change in
the relative proportion of the fluid and solid constituents of the
urine, or upon an absolute increase or decrease of the solid portions.
Any change in the absolute amount of solid matter excreted in the urine
must depend upon changes in the composition of the blood, or in the
circulation of the blood through the kidneys, or in the structure of
the kidneys themselves. All these three conditions seem to exist in
Bright's disease, and either together or separately may diminish the
daily excretion of solid matter.
It is not necessary here to enumerate the different solid constituents
of {75} the urine. A change in the amount of many of them merely
indicates disorders of the digestive process. Urea seems to be the most
important of the excretory substances, and its quantity is regularly
diminished both in acute and chronic Bright's disease.
Blood is found in the urine in a considerable number of cases of
Bright's disease. If it is present in large quantities, the urine will
be of a reddish color; if in smaller quantities, of a smoky color; and
if in still smaller quantities, the color will not be changed. Blood is
found regularly with acute diffuse nephritis, with the more severe
cases of acute parenchymatous nephritis, with the exacerbations of
chronic diffuse nephritis, and with suppurative nephritis. The blood
seems to be derived from the tufts of vessels in the Malpighian bodies.
Albumen in the urine is a very common symptom of renal disease, but it
is not confined to such cases. It is also found without any structural
lesions of the kidneys.
1. There are some individuals whose urine, for many years, will contain
small quantities of albumen, and yet their general health is good and
they never develop any renal symptoms. In some of these cases the urine
is always somewhat diminished in quantity, and in some there is also a
little sugar in the urine.
2. In a large number of perfectly healthy persons small amounts of
albumen will appear as a temporary condition after muscular exercise,
sea-bathing, eating certain kinds of food, etc.
3. Albumen may be present in considerable amount for weeks or months in
the urine of young persons, and then disappear altogether. The general
health may continue good or be somewhat depreciated. After a time the
albumen disappears and the patients have no further trouble.
4. General convulsions, concussion of the brain, and transfusion of
blood often produce a temporary albuminuria.
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