The morbid effects of the retention in the blood of the elements of the urinary secretion / by William Wallace Morland.

Date:
1861
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Licence: Public Domain Mark

Credit: The morbid effects of the retention in the blood of the elements of the urinary secretion / by William Wallace Morland. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    Basse, according to Dr. Braun, has never seen eclampsia puerperalis without Bright’s disease. The necroscopic and microscopic observations of edl, Gustav Braun, Lumpe, Becker, Devilliers, Regnauld, Simpson, Blot, Cahen, Wieger, Litzmann, Credfe, Sabatier, and Bohl have contributed to establish the theory propounded in Dr. Braun’s volume. In reference to the etiology of “eclampsia parturientium” (“uraemic eclampsia” of Braun), Romberg1 * only hints at the agency which Braun has distinctly announced as, in his opinion, the chief efficient cause. Thus, while the latter ably demonstrates his views as to the retention of urea, and the accompanying albuminuria, the former refers to “retention of urine owing to pressure of the gravid uterus upon the bladder;” and afterwards adds: “Future investigations must determine whether albuminuria, which often supervenes during pregnancy, may, when fully developed during the last months, possess any etiological influence.” The “investigations” of Braun and others certainly seem, if not already to have determined this point, likely to lead shortly to a satisfactory settlement of the whole ques- tion. Supposing, then, in conformity with the new doctrines thus announced, that the convulsive attacks and intervening coma observed in puerperal patients are owing to toxaemia by retained urea, let us examine the col- lateral results of such a condition—first, in regard to the mother; and next, as respects the foetus. Saving already detailed the general effects produced upon the system by uraemic intoxication, we may properly direct our notice, at present, to the influence exerted upon the puerperal state, and upon the life of the mother and that of the foetus. Referring to our previous enumeration of the results, both vital and post-mortem, which are observed after genuine uraemic convulsions, we would only add thereto that the uterus and its appendages are generally found healthy after eclampsia puerperalis, or, at all events, do not neces- sarily deviate from their usual condition after labour has terminated; unless, of course, there has been some pre-existent or concomitant disease in, or alteration of, the organs. The infrequency of metritis and peritonitis is mentioned by some observers ;3 but Churchill3 speaks of the great tendency to abdominal inflammation after the labour is over, and quotes Denman, who first mentioned this, and Collins and others, as confirming it. Braun also refers to the danger of puerperal affections coming on after eclampsia, especially if “an epidemic of zymotic diseases prevails.” The spleen is said to exhibit “the large dimensions it possesses in preg- nancy and childbed.”4 1 A Manual of the Nervous Diseases of Man ; Sydenham Society’s edition, Lon- don, 1853, vol. ii. p. 189. a Romberg, Velpeau, et al. 5 Theory and Practice of Midwifery. 4 Braun, op. cit., p. 62.