ITS ABNORMAL CONSTITUENTS. 423 



especially in cholera. Bright's granular degeneration of the kidneys 

 is, however, very often present with ursemea, so that these diseases 

 appear to owe their albuminous urine solely to the access of Bright's 

 disease; there are, however, numerous cases, as for instance of 

 scarlatina and erysipelas, in which albumen is only transitorily 

 present in the urine for one or two days, and is accompanied by the 

 epithelial cylinders, which have been already described. In these 

 cases there is merely simple renal catarrh, in which, as in catarrhal 

 affections of all other mucous membranes, there is desquamation 

 of epithelium and a secretion of mucus. 



In dropsies.) at least in their more advanced stages, albumen is 

 often found in the urine without the simultaneous existence of de- 

 generation of the kidneys ; in these cases there are two ways in 

 which we can explain the manner in which this substance escapes 

 from the renal capillaries : either the blood has already become so 

 hydraemic that it not merely transudes through the capillaries of 

 the peritoneum, of the subcutaneous cellular tissue, and of other 

 organs, but also of the kidneys themselves, and that consequently 

 some albumen is thus added to the substances which are ordinarily 

 separated by the kidneys ; or we may assume that those organic 

 diseases of the thoracic or abdominal organs, which occasion a 

 stasis of the circulation in the capillaries and veins of the abdomen, 

 and thus give rise to copious transudations, also set up a similar 

 condition in the capillaries and veins of the kidneys, by which an 

 effusion of albumen into the urinary canals is induced. Meyer* 

 has made some beautiful experiments on rabbits which support 

 this latter view. On compressing with a ligature sometimes the 

 renal vein on one side and sometimes the inferior vena cava, by 

 which the increased hydrostatic pressure of the blood must dilate 

 the renal capillaries, he always found albumen in the urine collected 

 after the operation ; and on tying the renal vein on one side he only 

 found albumen in the urine that escaped from the exposed ureter 

 of the side on which he operated, and here it was very abundant. 



Organic diseases of the thoracic and abdominal organs some- 

 times occasion an escape of albumen though the kidneys, without, 

 however, the simultaneous occurrence of any dropsical transuda- 

 tion ; here the albuminuria probably only arises from the above 

 mentioned causes. 



If, in consequence of any affection of the urinary passages, 

 blood, or true pus, should find its way into the urine, it is c 

 that that fluid must then become albuminous. 

 * Arch, f. phys. Heilfc lid, 3, S, 



