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Nocturnal polyuria would indicate a uremic death in about 50 percent of the patients, and typical headache or cerebral symptoms show the probability of uremic death in more than 50 percent, and death from apoplexy in a large number of the other 50 percent As just stated, rapid loss of weight is a bad symptom. Diabetes generally, on the other hand, causes a low blood pressure.
Kraepelin mentions the epileptiform convulsions of uremia as well as delirious and comatose conditions, especially those in advanced pregnancy. These uremic conditions may be both acute and chronic. But Kraepelin has not been able to convince himself of the existence of a clearly defined uremic insanity unless the delirious condition just mentioned may be regarded as such
One of the most daring and successful on record was the capture of the French 20-gun ship-corvette Chevrette, while lying under some batteries in Camaret Bay, by the boats of the Doris, Beaulieu, and Uremic, forming part of the Channel Fleet under Admiral Cornwallis, stationed off Brest Harbour.
"The coroner is called in, and, as his physician, I must advise him. The family physician has pronounced it due to natural causes, the uremic coma of latent kidney trouble. Some of the newspapers, I think the Star among them, have hinted at suicide. And then there are others, who have flatly asserted it was murder." The coroner's physician paused to see if we were following him.
Prentiss of Washington, D.C., in 1881 reported a remarkable case of pilocarpin idiosyncrasy in a blonde of twenty-five. He was consulted by the patient for constipation. Later on symptoms of cystitis developed, and an ultimate diagnosis of pyelitis of the right kidney was made. Uremic symptoms were avoided by the constant use of pilocarpin.
Inasmuch as we know that creatin, creatinin and potassium salts irritate the animal cortex, Ziehen notes that psychopathic phenomena may occur in man as a result of slight uremic changes.
A frequent condition causing a slowing of the heart is the presence of bile in the blood, typically true of catarrhal jaundice. Uremic poisoning and acidemia and coma of diabetes tray cause a pulse to be very slow. Not infrequently after parturition the heart quiets down from its exertion to a rate below normal.
The literature is not without suggestions as to the possible correlation of renal and mental disorder. Ziehen, for example, remarks that nephritis brings about mental disease in two ways, through vascular changes which very frequently accompany chronic nephritis and other uremic changes in the blood.
Binswanger states that the mental disorders occurring in acute and chronic nephritis are either toxemic psychoses on uremic bases, or due to arteriosclerosis. In the latter cases, he states that the disease pictures are as a rule characterized by grave disturbances of emotions, chiefly of a depressive character.
It may save a heart that is in agony from tension, and may prevent an apoplexy. It is of little value except temporarily in uremic conditions, but at other times it may, at the time, save life and allow other methods of reducing the dangerous tension to become effective.
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