The anatomic histological processes of Bright's disease and their relation to the functional changes : lectures delivered in the Russell Sage Institute of Pathology, City Hospital, New York, during the winter of 1909 / by Horst Oertel.

  • Oertel, Horst, 1873-1956.
Date:
1910
Catalogue details

Licence: Public Domain Mark

Credit: The anatomic histological processes of Bright's disease and their relation to the functional changes : lectures delivered in the Russell Sage Institute of Pathology, City Hospital, New York, during the winter of 1909 / by Horst Oertel. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    tory seems improbable, for the reason that it only partly covers the iilomerulus, that it has not the morphotic character of secre- tory cells, and that, under pathological conditions, water dis- charge continues after its loss, unless there is a mechanical obstruction to its outflow, or the tuft becomes diseased. This is particularly well illustrated in cases of contracted kidney, and in some cases of stasis, when the epithelium has been lost, but the tuft itself remains and still functionates. It is further corrob- orated by the fact that the reaction of the glomerular product has l^een found alkaline, and that on increased diuresis the urine becomes alkaline, and lastly by the constant presence of vary- ing faint traces of serum albumin in all urines. The glomer- ulus, therefore, is that organ whose duty it is to regulate the concentration of the blood. Now, we must remember that this water, which is furnished by the process of transudation from the glomerulus, is modified on its way. That modification cannot, I believe, be explained, at least at present, on a physical basis. We must assume that the epithelium of the convoluted tubules, as well as that of the other tubules, plays an active part in the modification of that fluid to urine. The reasons for it are these: The osmotic pres- sure of the urine is much higher than that of the blood, and it contains specific substances, and in such varying amounts, that an active part of these epithelial glandular cells is made most probable. It is undoubtedly for this reason that the blood is furnished to the epithelial cells of the tubules in a much more concentrated form. The change from alkaline blood plasma to acid urine, however, can be explained on physical basis. The anatomical arrangement of the tubules indicates that there must be stagnation of the transuded water in the con- voluted tubules. This may be for the sake of water resorption, but to me it is rather more for the purpose of complete solution of nitrogenous elements discharged by the epithelium of these