The Purbis oration on some points in the diagnosis and treatment of granular kidney : delivered before the West Kent Medico-Chirurgical Society / by Samuel West, M.D. Oxon., F.R.C.P. Lond., consulting physician to St. Bartholomew's Hospital, etc.

  • West, Samuel
Date:
[1913?]
Catalogue details

Licence: In copyright

Credit: The Purbis oration on some points in the diagnosis and treatment of granular kidney : delivered before the West Kent Medico-Chirurgical Society / by Samuel West, M.D. Oxon., F.R.C.P. Lond., consulting physician to St. Bartholomew's Hospital, etc. Source: Wellcome Collection.

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    IB dinner with some champagne. He had it and felt all the better. I advised him to continue with a liberal but plain diet. He soon picked up and looked a different being. In two or three weeks’ time he was well enough to go home. I cautioned him to live at a lower rate. I heard subsequently that he had gradually resumed his ordinary way of living,, though he was careful in respect of wine and tobacco, delegated as much of his work as he could, and took more frequent holidays. Though the medical man had no doubt good reasons for his anxiety at the commencement of the patient’s illness, it is clear that the lowering treatment had been continued too long until the health suffered seriously. It is interesting to know that in spite of the stringent and lowering regime, and the effect this had had upon the health, the effect upon the blood pressure was nil. I saw the patient again two years or so later. He had been in perfect health, and was passing through London on his way home after a good holiday abroad. The weather was very hot, and he was overcome one day with what he called a faint. When I saw him there was slight weakness of the left arm which he complained of, as well as some thickness of speech, and the left side of the face was some¬ what smoothed out, and moved imperfectly. He had evidently had some incomplete thrombosis of one of the subdivisions of the right Sylvian artery. In a few days he had greatly improved and was able to continue his journey to his home, which he reached safely. My account of him at present is incomplete, but I hear he is much better, though not quite well or strong enough to undertake his old work. This attack is, no doubt, the consequence of the degeneration in his arteries to which I have said the high pressure was likely to lead. The most careful examination failed throughout to give any evidence of renal disease. The arteries were not at all thickened—indeed, if anything, they were unusually thin and supple for his age. Albuminuria. Of albuminuria there is not much that I need say. The amount of albumin is usually small, sometimes merely a trace. The most important fact about it is that it may be absent at some time of the day or even be absent altogether for days or weeks. As a rule, however, it is persistent, and does not vary much in amount from day to day or at different times of the day. Albuminuria is a symptom, and not a. disease. It