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Updated: June 27, 2025
Motley's case was a striking illustration that the renal disease of so-called Bright's disease may supervene as part and parcel of a larger and antecedent change in the blood-vessels in other parts than the kidney. . . . I am, my dear sir, Yours very truly, WILLIAM W. GULL. To OLIVER WENDELL HOLMES, ESQ. I first saw Mr.
Now if we omit an estimate of the undigestible remains of the food, we find that the main bulk of what daily leaves the body consists of water, carbon dioxid, and certain solid matters contained in solution in the renal secretion and the sweat. The chief of these solid matters is urea, a complex product made up of four elements, carbon, hydrogen, oxygen, and nitrogen.
The imperfect return of the blood through the inferior vena cava also interferes with the return of the blood through the renal veins, and more or less renal congestion occurs, with a concentrated urine and perhaps an albuminuria as the result.
He adds that these are all too frequently the forerunners of arteriosclerotic brain degeneration. A brief mention of renal disease in the general etiology of mental disease is made by Ballet.
We find in these a urinary bladder that proceeds from the lower wall of the hind end of the gut, and serves as receptacle for the renal secretions. This organ has been transmitted to the Amphibia, as we can see in the frog.
But then something struck a familiar note, and he remembered studying the peculiar Moruan renal system, in which the creature's chemical waste products were filtered from the bloodstream in a series of tubules passing across the peritoneum, and re-absorbed into the intestine for excretion.
Psychic disturbances, congested portal or renal system, hard mental or muscular work, etc., etc., induce increased pressure of the general circulation, and so simultaneously the intra-ocular pressure.
The first forms the clusters in the Malpighian capsules and receives the blood directly from the smallest arteries. From the last set of capillaries the blood is passed into veins which leave the kidneys where the artery branches enter, uniting there to form the main renal veins. *Work of the Kidneys.*—Why should the blood pass through two systems of capillaries in the kidneys?
Of course it should be repeatedly emphasized that chronic interstitial nephritis may be in evidence with either albumin or casts alone, or without either being present. Janeway sums up his conclusions by stating that "from the time of the development of symptoms indicative of cardiovascular or renal disease, four years will witness the death of half the men and five years of half the women.
Of course the most important concomitant symptoms of high pressure are cardiac, renal, and cerebral, and the typical headache, as he terms it, is a symptom of serious import. In considering headache in persons over 40, we must eliminate the eye headaches produced by the need of presbyopic glasses or by the need of stronger lenses, as this need is a frequent cause of headache.
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