On the morbid conditions of the urine, dependant upon derangements of digestion

Front matter

22101804767

The Library of the Wellcome Institute for the History of Medicine

MEDICAL SOCIETY OF LONDON DEPOSIT

Preface

In the present work it is intended to confine the attention to those urinary derangements which are the result of chemical changes occurring within the body, as distinct from those morbid conditions of the urine which are directly associated with disease of the renal organs or of the genito-urinaryjpassages, or those which, like diabetes and temporary albuminuria, are the result of disturbance of the circulation in the hepatic and renal vessels.

During the last twenty years physicians have paid but little regard to these derangements, which during the earlier part of the century were the subject of exhaustive research and furnished the materials for keen discussion and controversy. Three causes may be assigned for this neglect. In the first place the attention of pathologists has of late years been almost exclusively directed to histological research. Secondly, owing to the dominant position uric acid has assumed in humoral pathology there has been a tendency to refer these derangements to the same category and to speak of them somewhat indiscriminately as connected with " gouty " proclivities, and thus to overlook some of their distinctive characters. Lastly, there is no department of clinical medicine which is generally so perfunctorily performed as the examination of the urine in disease vill PEFEACE

As a rule, we are content with determining the presence or absence of albumen or sugar, the nature of deposited matters, and recording the specific gravity and reaction without, however, reference being made to the conditions as regards time, food, &c, at which the urine was passed. "Whilst it seldom happens that any attempt is made to determine the actual acidity or the amount of solid matter passed daily, yet it is almost entirely by this means that we can hope to obtain an insight into the nature of the metabolic changes occurring within the body.

But whilst this branch of urinary pathology has been comparatively neglected of late years, physiological chemistry has made considerable progress, and this is especially the case with reference to the physiology of digestion. Not only have recent discoveries elucidated much that was obscure, but they have also opened up new points of view. It is, therefore, with the aid that physiological chemistry now affords us that it is proposed to pass under review the facts connected with the subject of the morbid conditions of the urine dependant on derangements of digestion. Much of the material of which the present volume is comprised has already appeared in the pages of the ' Lancet ' during the last five years. The encouragement the author received during their publication in a separate and detached form leads him to hope that now they are arranged in a more systematic manner, they may prove serviceable towards the elucidation of these still difficult problems in chemical pathology.

Queen Anne Steeet,

Cavendish Squaee, W.

March Voth, 1882.

Deeangements Associated with Deposits of Oxalate