一种新的治疗方法Gonorrhœa

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In order to distinguish between acute and chronic desquamative nephritis with certainty, it is necessaxy to examine with the microscope whether the epithelial scales are entire or disintegrated, the acuteness of the attack being capable of estimation by the proportion of perrect cells found, and also by the presence of 'lood corpuscles, which are rarely found in the chronic form. The symptoms, pathology, and treatment of these diseases are given in an admirable style, and with great minuteness, indeed, so much so, that it is out of the question to attempt any ,analysis in the limited space we can afford. But there is one point which has caused a considerable controversy, between our author on the one 'hand, and Mr. Simon, followed by Rokitanski sad Paget on the other. This point of dispute 'is relative to the primary cause of renal cysts. Dr. Johnson maintains that they are simply dilated tubes, and that there is no difficulty in tracing them through every degree of dilatation from the natural size up to cysts visible to the naked eye. He also says that with care he can always detect, in contact with these cysts, unequivocal portions of elongated tube, having the same structure as the other parts, and evidently continuous with them, though this is concealed by the tissue in which they are enveloped. On the other hand, Mr. Simon contends that they are abnormal developments of epithelial germs, his theory being that, \" certain diseases of the kidney, (whereof subacute inflammation is by far the most frequent,) tend to produce a blocking of the tubes; that this obstruction, directly or indirectly, produces rupture of the limitary membrane; and that then, what should have been the intra-mural cell-growth, continues, with certain modifications, as a parenchytic development.\" For the argaments pro and con, we must refer our readers to the book itself, for though highly interesting they are too long for insertion. Another disputed point is as to the development of new fibrous tissue; but here our author and Mr. Simon are both opposed to its occurrenoe except in very rare instances. But it appears that desquamation does not alwavs coexist with nephritis: and hence we must not always give a favourable prognosis on the absence of epithelial scales from the urine. Indeed, according to our author, if you have nephritis unaccompanied by this epithelial desquamation, the danger is much increased, and in chronic cases we frequently find, that instead of the morbid poison being eliminated, fatty degeneration of the kidney takes place in the granular form, terminating but too frequently in death. The mottled variety of fatty degeneration, on the contrary, is rarely preceded by nondesquamative nephritis, and is a slow insidious disease, not even to be detected by a microscopio examination of the urine. The remaining chapters-viz,, the eighth. ninth, and tenth, are occupied with a description of nephritis when followed by a secretion of pus; scrofulous disease of the kidney, cancer, and luematuria. Each of these sections is exceedingly interesting, but still as they have received no remarkable elucidation from the investigations of our author, we need only remark that they embody all that is known on the respective subjects. Having thus alluded1 as far as our space wiU allow, to this highly interesting work of Dr, Johnson's, we have only to recommend our readers to examine it and judge for themselves, as to the accuracy of his views. With regard to treatment we have yet much to learn, but as we have gained one step in advance from the correct anatomy to the pathology of the kidney, so we hope hereafter to progress still further in the successful treatment of those diseases, which are even now less under the control of medicino than we hope will eventually be the case.","PeriodicalId":20791,"journal":{"name":"Provincial Medical and Surgical Journal","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"1852-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"On a New Way of Treating Gonorrhœa\",\"authors\":\"\",\"doi\":\"10.1136/bmj.s1-16.18.462\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"tive process li:ke the desquamation of the cuticle is frequently attended by injurious results, which are entirely absent in scarlatina, for no accumulation of cuticle can possibly take place. 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引用次数: 0

摘要

像角质层的脱屑这样的过程经常伴随着有害的结果,这在猩红热中是完全没有的,因为角质层不可能积累。另一方面,Frericks认为脱屑只是白蛋白和纤维蛋白渗出的偶然结果,这些蛋白和纤维蛋白在管道中凝固后缠绕上皮,并在逃逸到肾盂时将其带走。这是一项艰巨的任务——我决定这么微妙的一点,但毫无疑问,在尿液中发现了大量的上皮鳞片,这是诊断这种疾病的完美方法。为了明确区分急性和慢性脱屑性肾炎,有必要在显微镜下检查上皮鳞片是完整的还是崩解的,可以通过发现的完美细胞的比例来估计发作的严重程度,也可以通过血球的存在来估计,这在慢性形式中很少发现。这些疾病的症状、病理和治疗都以一种令人钦佩的方式给出,而且非常详细,事实上,如此之多,以至于在我们所能承受的有限篇幅内试图进行任何分析是不可能的。但有一点引起了相当大的争议,一方是我们的作者,另一方是西蒙先生,其次是罗基坦斯基和佩吉特。这一争议点与肾囊肿的主要原因有关。约翰逊医生坚持认为,它们只是扩张的管子,从自然大小到肉眼可见的囊肿,追踪它们的每一个扩张程度都是没有困难的。他还说,只要小心,他总能在与这些囊肿接触的地方发现细长管的明确部分,这些部分与其他部分具有相同的结构,并且显然是连续的,尽管这被包裹它们的组织所掩盖。另一方面,西蒙先生认为它们是上皮细菌的异常发育,他的理论是,“某些肾脏疾病(亚急性炎症是迄今为止最常见的)往往会导致管道堵塞;这种阻塞,直接或间接地,导致肌膜破裂;然后,原本应该是壁内细胞生长的东西,经过一定的修饰,继续作为薄壁细胞发育。”对于赞成和反对的论点,我们必须让读者参阅本书本身,因为尽管它们非常有趣,但太长了,无法插入。另一个争议点是关于新纤维组织的发展;但在这里,我们的作者和西蒙先生都反对这种情况发生,除非在极少数情况下。但似乎脱屑并不总是与肾炎共存,因此我们不能总是对尿中没有上皮鳞片给予良好的预后。事实上,根据我们的作者,如果你患有肾炎而不伴有这种上皮脱屑,危险就会大大增加,在慢性病例中,我们经常发现,不是病态的毒素被消除,而是肾脏的脂肪变性以颗粒形式发生,最终以死亡而告终。相反,斑驳的脂肪变性很少发生在非脱屑性肾炎之前,是一种缓慢潜伏的疾病,甚至通过尿液的显微镜检查也无法发现。其余各章,即第八章。第九章和第十章描述了肾炎之后脓的分泌;肾脏坏疽性疾病、癌症和血尿。每一节都是非常有趣的,但是由于我们的作者的研究还没有得到显著的阐明,我们只需要指出,它们体现了我们在各自主题上所知道的一切。在篇幅所允许的范围内,我们已经提到了约翰逊博士的这部非常有趣的著作,现在我们只建议读者们仔细研究一下,并自行判断他的观点是否准确。关于治疗,我们还有很多东西要学,但由于我们已经从正确的解剖到肾脏的病理前进了一步,所以我们希望今后在成功治疗这些疾病方面取得进一步的进展,这些疾病即使现在在医学控制下也比我们希望的要少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
On a New Way of Treating Gonorrhœa
tive process li:ke the desquamation of the cuticle is frequently attended by injurious results, which are entirely absent in scarlatina, for no accumulation of cuticle can possibly take place. On the other hand, Frericks considers that the desquamation is only an accidental consequence of an effusion of albumen and fibrin, which entangles the epithelium after coagulating in the tubes 'and carries it off in its escape into -the pelvis of the kidney. It is a difficult task -L decide upon so delicate a point, but there can 'be no doubt of the fact that epithelial scales are found in the urine to an enormous amount, and -are perfectly diagnostic of the disease. In order to distinguish between acute and chronic desquamative nephritis with certainty, it is necessaxy to examine with the microscope whether the epithelial scales are entire or disintegrated, the acuteness of the attack being capable of estimation by the proportion of perrect cells found, and also by the presence of 'lood corpuscles, which are rarely found in the chronic form. The symptoms, pathology, and treatment of these diseases are given in an admirable style, and with great minuteness, indeed, so much so, that it is out of the question to attempt any ,analysis in the limited space we can afford. But there is one point which has caused a considerable controversy, between our author on the one 'hand, and Mr. Simon, followed by Rokitanski sad Paget on the other. This point of dispute 'is relative to the primary cause of renal cysts. Dr. Johnson maintains that they are simply dilated tubes, and that there is no difficulty in tracing them through every degree of dilatation from the natural size up to cysts visible to the naked eye. He also says that with care he can always detect, in contact with these cysts, unequivocal portions of elongated tube, having the same structure as the other parts, and evidently continuous with them, though this is concealed by the tissue in which they are enveloped. On the other hand, Mr. Simon contends that they are abnormal developments of epithelial germs, his theory being that, " certain diseases of the kidney, (whereof subacute inflammation is by far the most frequent,) tend to produce a blocking of the tubes; that this obstruction, directly or indirectly, produces rupture of the limitary membrane; and that then, what should have been the intra-mural cell-growth, continues, with certain modifications, as a parenchytic development." For the argaments pro and con, we must refer our readers to the book itself, for though highly interesting they are too long for insertion. Another disputed point is as to the development of new fibrous tissue; but here our author and Mr. Simon are both opposed to its occurrenoe except in very rare instances. But it appears that desquamation does not alwavs coexist with nephritis: and hence we must not always give a favourable prognosis on the absence of epithelial scales from the urine. Indeed, according to our author, if you have nephritis unaccompanied by this epithelial desquamation, the danger is much increased, and in chronic cases we frequently find, that instead of the morbid poison being eliminated, fatty degeneration of the kidney takes place in the granular form, terminating but too frequently in death. The mottled variety of fatty degeneration, on the contrary, is rarely preceded by nondesquamative nephritis, and is a slow insidious disease, not even to be detected by a microscopio examination of the urine. The remaining chapters-viz,, the eighth. ninth, and tenth, are occupied with a description of nephritis when followed by a secretion of pus; scrofulous disease of the kidney, cancer, and luematuria. Each of these sections is exceedingly interesting, but still as they have received no remarkable elucidation from the investigations of our author, we need only remark that they embody all that is known on the respective subjects. Having thus alluded1 as far as our space wiU allow, to this highly interesting work of Dr, Johnson's, we have only to recommend our readers to examine it and judge for themselves, as to the accuracy of his views. With regard to treatment we have yet much to learn, but as we have gained one step in advance from the correct anatomy to the pathology of the kidney, so we hope hereafter to progress still further in the successful treatment of those diseases, which are even now less under the control of medicino than we hope will eventually be the case.
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