The American Journal of the Medical Sciences Vol. 59 - novo libro

Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: Art. IV.?On the Diagnostic Value of the Corpuscular Blood-Elements in the Urine of Bright1 s Disease. By Joseph G. Richardson, M. D., Microscopist to the Pennsylvania Hospital, Philadelphia. Most general practitioners of medicine, when called upon to investigate an obscure case of Bright's Disease, have probably felt the want of some more definite guides to the exact condition of the kidneys than those furnished by the proportion of albumen in the renal secretion, or the character of the tube casts which the urine contains; and although it seems at first sight an arduous task to attempt supplying the student with any additional aid beyond that afforded by the admirable manuals published by Doctor Dickinson, and, more recently, by Doctor Grainger Stewart, yet my connection with the hospital has enabled me to carry on some researches which, enlightened by the new discoveries in regard to pus and mucus, may serve to render certain doubtful cases of this affection somewhat clearer than they would be without such assistance. It seems remarkable, indeed, how meagre are the references to the dingnostic importance of blood in the urine made in the monographs above mentioned; the former of these gentlemen observing in respect to casts (p. 18): "If pus [white blood] cells are included, the inflammatory or catarrhal state has taken such hold of the tubes that the epithelial cells are replaced by pus globules. Blood globules will show that there has existed enough congestion to rupture the Walpighian capillaries." While the latter dismisses the subject with little more than the statement (p. 15): "And, lastly, some [casts] are found in which blood corpuscles in varying quantity are present. Along with the tube-easts, and sometimes in large quantity, blood corpuscles altered by the action...