Diseases of the Urinary Organs 



Section I. 



DISEASES OF THE KIDNEYS. 



1. Albuminuria. 



Etiology. Albuminuria is observed principally in those 

 diseases of the kidneys in which the glomeruli or the epithelial 

 cells are affected; affections of the epithelia of the tubuli 

 uriniferi may also lead to albuminuria by causing the serum 

 albumin of the surrounding tissues to pass into the lumen of 

 the tubules. Albuminuria represents therefore an almost con- 

 stant symptom of inflammatory and degenerative processes in 

 the kidneys. 



In like manner other nutritional disturbances of the 

 glomerular epithelia may cause albuminuria; disturbances in 

 the circulation of the blood and also changes in the composition 

 of the blood in the various blood diseases act in this manner. 



The immediate cause of the albuminuria which occurs in 

 connection with skin diseases, with certain diseases of the ner- 

 vous system (cerebral hemorrhage, inflammation of the spinal 

 cord, convulsions) and with some very painful affections, has 

 not yet been determined definitely. Possibly the cause lies in 

 disturbances in the innervation of the renal vessels and in the 

 nutritive disturbances in the epithelial cells which occur in 

 consequence. 



The glomeruli retain only serum albumen, wLIIb .ither albuminous substances, 

 8' S-! 6gg albimien injected directly into the bloqd or hemoglobin liberated through 

 the destruction of red blood cells, easily pass into the urine. 



Traces of albumen are sometimes found in the urine of healthy individuals 

 (physiological albuminuria) ; in man especially after generous meals, severe muscular 

 exertion, sexual excitement, copious perspiration, in depressed conditions of the 

 mind and during pregnancy. Simader examined the urine of several hundred 

 healthy animals by Posner's method, and found that minute quantities of albumen 

 form a normal constituent of animal urine, and that even a fairly considerable 

 quantity of urine, up to 0.01-0.03% in the urine of dogs and hogs, less in the urine 

 of ruminants and very rarely in that of horses is devoid of any pathological 

 significance. The albumen which occurs under normal conditions in the urine 

 seems, however, to be mostly nucleo-albumen and mucin. Fettick has shown that 

 in the dialyzed urine of healthy animals acetic acid does not cause cloudiness, 

 Vol. 1—62 977 



