44 DISEASES OF THE KIDNEY. 



results are ascribed to the more intense grades of this lesion. Thus 

 it is supposed in acute forms often fatally to cripple the action of 

 the heart. - 



The condition is also found in the bodies of pregnant and puer- 

 peral women. At present we have no definite knowledge as to how 

 pregnancy affects the minute structure of the kidney and other or- 

 gans in these cases.] 



The most common and frequently the sole symptom of parenchym- 

 atous degeneration of the kidney is the presence of albumen in the 

 urine. We may say, too, that whenever there has been albuminuria 

 during pregnancy or during grave disease, the renal epithelium will 

 be found to be in a more or less advanced state of degeneration after 

 death. How often the question is asked by the anatomist during the 

 autopsy, whether the patient had albuminous urine ! On the other 

 hand, I will not venture to state positively that the albuminuria, which 

 eo often accompanies the conditions above referred to, is always the 

 result of degeneration of the epithelium of the kidney, or that degen- 

 eration of the renal epithelium is always attended by albuminuria. 

 The quantity of albumen which the urine contains is probably never 

 so great in parenchymatous degeneration as in amyloid degeneration, 

 and parenchymatous inflammation of the kidney. . When it arises after 

 acute febrile disease, it never produces dropsy. This symptom is often 

 absent, too, during pregnancy accompanied by parenchymatous renal 

 degeneration and albuminuria. Sometimes, however, there is a mod- 

 erate degree of dropsy, and in rare instances a very large one. When 

 it accompanies pregnancy, it is sometimes a source of danger, owing 

 to the eclamptic attacks which it provokes during and immediately 

 after parturition, and of which we shall have more to say when we 

 come to treat of diseases of the nerves. 



If the original disease terminate in recovery, the nutritive disorders 

 of the renal epithelium to which it has given rise are also completely 

 repaired. Soon after delivery the albuminuria and dropsy disappear 

 in almost all cases, another proof that the malady in question is not 

 to be confounded with interstitial nephritis. We are quite ready to 

 admit that in most cases of eclampsia puerperarum there is renal dis- 

 ease ; but we deem it quite inadmissible to attribute the albuminuria. 

 dropsy, and eclampsia to " Bright's disease." 



After what has been said already regarding parenchymatous degen- 

 eration, further discussion of its treatment becomes superfluous. We 

 shall treat hereafter of the proper management of the eclampsia. 



