34 



convo- 



kidney, especially of the glonierule ; the epithelium of the 

 luted tubules may also be essential in the production of albu- 

 minuria. These cells normally prevent the albumin from filtering 

 through with the other elements of the plasma. Albuminuria is 

 also dependent upon renal lesions, sometimes primary as in 

 nephritis, sometimes consecutive as in alteration in the blood or 

 a disturbance in the circulation. Acute nephritis, chronic neph- 

 ritis, fatty or amyloid degeneration interfere with the process of 

 dialysis. 



Bacteria may exercise a traumatic action upon the renal 

 epithelium and cause desquamation or degeneration, obstruct the 

 vessels, modify blood pressure, or by the excretion of soluble 

 products irritate the parts. 



Changes in the Blood. The dialysing membrane cannot 

 stand with impunity any adulteration of the blood. The passage, 

 in the kidney, of any such substance as biliary pigment in icterus ; 

 glucose in diabetes ; poisons, such as alcohol, lead or mercury, or 

 toxic gases, render the urine albuminous. 



Subcutaneous injections of solutions of extractives (leucin, 

 ty rosin, creatinin, xauthin and hypoxanthin) cause degeneration 

 of the epithelium of the kidneys and albuminuria. The subcu- 

 taneous injection of tincture of cantharides causes, in a few min- 

 utes, the production of an albuminous exudate in the glomerules. 

 Although the limit of saturation of the blood plasma by albumin 

 may be unknown, it is none the less evident that a superabun- 

 dance of the substance (albumin) in the vessels causes albumi- 



nuria. 



The existence of a physiologic albuminuria is still doubtful in 

 the domestic animals ; for Frohner, who has examined the urine 

 of a number of healthy horses, has found only two cases in which 

 albumin was present. In man it has boen demonstrated to be due 

 to severe muscular exercise, slight cold, and nitrogenous diet. 



Disturbance of Circulation. Too great a variation in blood 

 pressure will cause albuminuria. 



Renal emboli, section of vaso-motor nerves of the kidney, 

 medullary lesions, etc., cause albuminuria by causing an active 

 congestion of the kidney. Venous stasis, organic affection of the 

 heart, of the liver, presence of fetus, etc., cause albuminous urine. 



The urine may be less fluid. Bacteria may frequently cause 



