710 DISEASES CONNECTED WITH THE KIDNEYS, ETC. 



CHAPTER L. 



diseases connected with the kidneys and their 

 functions. 



General Considerations. 



In considering even very cursorily the aifections of the 

 kidneys, whether manifested by simple disturbance of their 

 normal functions, or partaking of the more serious condition 

 of textural change, it is neither correct nor safe to do so apart 

 from a regard to the condition or character of their peculiar 

 secretion, the urine. 



This, although in all instances possessed of much similarity, 

 and the secretion of one animal being, to a certain extent, 

 typical of the same secretion in others, is rarely in any indi- 

 vidual instance an exact counterpart of its composition at any 

 other period even in the same animal. 



Although we are even yet in the dark regarding many agen- 

 cies and influences which determine the state of this secre- 

 tion, and of the modes through which changes are produced, 

 we yet know enough to teach us that neither in health nor 

 yet in disease is the urinary secretion at all times, either in 

 similar animals or individual specimens, of uniform amount or 

 character. In health, every change and exchange, vital or 

 purely chemical, occurring in the body influences both the 

 composition and dynamic relations of the blood, and in this 

 way largely determines both the amount and quality of the 

 material eliminated by the kidneys. In disease of the inti- 

 mate structure of these glands, we encounter material altera- 

 tions in their secretion ; but probably these alterations are as 

 extensively and perfectly marked when the textural lesions 

 are not in the kidney, but referable to primary htBrnal con- 

 tamination, or to elementary changes in some other tissue or 

 organ of the body ; the results of such changes, in the form 

 of disintegrated plasmic material, finding admission into the 

 blood, and loading or altering it in various ways. 



Knowing that such changes and alterations of the several 

 activities are ever taking place, and that such disturbances or 

 variations in these exchanges may be perfectly consistent Avitli 



