ALBUMEN. 345 



formerly made to constitute a special disease. Simon even asserts 

 that he has often found albumen in the urine of persons, at all 

 events, apparently healthy. In many acute and chronic diseases^ 

 unconnected with affections of the kidneys, albumen not unfre- 

 quently appears for a short time in the urine, as, for instance, in in- 

 flammations of the thoracic organs, acute articular rheumatism, inter- 

 mittent fevers, typhus, measles, cholera, insufficiency of the valves 

 or contraction of the orifices of the heart, also in chronic affections 

 of the liver, and in pulmonary and peritoneal tuberculosis, espe- 

 cially towards the fatal termination of these diseases. The transi- 

 tory passage of albumen into the urine appears to depend in these 

 conditions on a change in the character of the blood, in conse- 

 quence of which the albumen is able to penetrate through the tissue 

 of the kidneys. It is, however, in affections of the kidneys, whether 

 acute or chronic, that albumen appears most constantly in the urine. 

 Bright's disease, is, as is well known, a term of very wide signifi- 

 cance, but if we limit it as much as possible, and merely include 

 under the term a degeneration of the tissue of the kidney, more 

 especially of the cortical substance, whether of a fatty or other 

 character, we may regard the presence of albumen in the urine as 

 a constant symptom of this disease. But in transitory renal catarrh, 

 such, for instance, as occurs in erysipelas nearly as frequently as 

 after scarlatina, albumen, together with the well known epithelial 

 cylinders of Bellini's ducts, is found as constantly in the urine as 

 in inflammatory affections of the kidneys, where it is associated 

 with the fibrinous plugs from the same ducts, and as in true 

 Bright's disease. It is almost unnecessary to observe that the 

 presence of pus or blood in the urine necessitates that of albumen, 

 but it is worthy of notice that a little albumen, together with mucus- 

 corpuscles is always found in uncomplicated severe catarrhs of the 

 mucous membrane of the bladder. 



The observations already made in reference to the occurrence of 

 albumen in the urine apply almost equally to its appearance in the 

 solid excrements. Albumen is always found in the excrements in 

 diarrhoea depending upon intestinal catarrh, and in diseases compli- 

 cated with this affection ; the quantity of the albumen increases, 

 moreover, in proportion to the degree in which the blood becomes 

 altered during the diarrhoea; hence, we find, that not only in 

 dysentery and cholera, in which so much stress has been laid on the 

 discharge of albumen, but also sometimes in Bright's disease, albu- 

 men, together with entire patches of cylindrical epithelium, (in some 

 cases the entire thimble-like coverings of the intestinal villi) is dis- 

 charged in masses by the rectum. 



