1885 v. 28 - Lane Medical Library Digital Document Repository

Notes on Albuminuria. 13
ly treated in season. Had seen many cases during previous years in
verification of the foot. In one case, in a boy six or seven years
old, after scarlatina, the renal secretion was nearly all albumen. He
recovered.
DR. VOEI.LER. At first to answer Dr. Cluness' paper in regard
to traces of albumen, which frequently are met with in the urine,
it can be said that such are of little importance. They have been
observed often enough after protracted over-exertion of mind or
body, and have quickly disappeared. A satisfactory explanation
is still wanting. We might suppose that imperfect inuervation
produces a greater permeability of tissue, and consequently allows
the albumen to transude. Albumen is not held.in solution by the
blood, but exists in that fluid in a molecular form.
There is another form of transient albuminuria called alimentary
albuminuria, in which the urine is temporarily rendered albuminous
by the use of highly albuminous food, as when a large quantity
of white of egg, or egg-albumen, has been swallowed after
fasting. It has been assumed that raw white of egg, or egg-albumen,
can be absorbed directly and unchanged from the stomach,
and be excreted again at once by the kidneys; while coagulated
albumen can only reach the blood vessels after previous digestion
and conversion into peptone. The case referred to by Dr. Cluness
may be explained by both causes—over-exertion of brain and
use of highly albuminous food at the same time. Light traces of
albumen appear, according to Senator, of Berlin, in the urine of
healthy individuals very frequently, and the only reason we did
not detect them before depended on the imperfection of our methods.
Consequently, traces of albumen do not,/>er se, justify rejection
of an applicant for Life Insurance, but demand further observation
before recommending its acceptance.
The transudation of albumen depends mainly on four causes,
two or more of which may act simultaneously. 1st, Great departure
of blood j)ressure from the normal; particularly venous congestion.
2d, Hydrsemia. 3d, Diseases of the kidney, where the
amount of albumen in the urine depends far more on the extent
of the disease than its intensity. (Brueke, of Vienna) 4th,
Disease of brain. (Meynert, of Vienna.) 5th, Changes of composition
of blood, which is not considered of great importance.
(Wagner, of Leipzig.) Of these causes, venous congestion and
hydrsemia are the most frequent. They are often united, one producing
the other; indeed, the experiments of the School o f Dor-