The neuritic form of albuminuric retinitis / by Arthur J. Ballantyne.

  • Ballantyne, Arthur J.
Date:
[1905]
Catalogue details

Licence: In copyright

Credit: The neuritic form of albuminuric retinitis / by Arthur J. Ballantyne. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    the time of admission. For several weeks the urine had been scanty and high-coloured, and micturition frequent. Not much headache, and no defect of sight, complained of. Good health until onset of present illness. Married, and ha.d had 15 children. Lips on admission somewhat livid. Respiration hurried and shallow. Pulse rather rapid, irregular, small; and soft. Temperature normal. General anasarca. Heart per- haps a Httle enlarged, with some accentuation of second sound at base. (Edema of bases of both lungs, and pleural effusion on right side, forty ounces of fluid being withdrawn by aspirator. Uniform enlargement of liver. Spleen not palpable. Some ascites. Urine, acid, specific gravity 1025, with a considerable quantity of albumen, but no blood: abundant tube casts, chiefly hyaline and finely granular. Eyes.—Marked strabismus convergens said to date from measles in childhood. O'phthalmoscopic Examinahon.—ln both eyes choked disc, tortuous vessels. A whitish patch bordered with pigment showing through lav a little beyond the temporal edge of the swollen disc. Retina normal. In left eye there was a flame-shaped hcemorrhage near the lower-outer margin of the disc. V.R. and L. = J. i with glasses. At a subsequent examination swelling of disc showed slight diminution, and atrophic crescent coming more distinctly into view at tem- poral side of each disc. , , j -i Progress —Southey's tubes were used for the limbs, and three days later paracentesis thoracis repeated. During some days patient was restless and mildly deHrious. Urme for some days scanty in spite of treatment. Albumen (at first 0.4 per cent.) showed shght diminution. Anasarca increased, and condition became, on the whole, worse. On 31st July, 1903, after addition of diuretin to other treatment, there was great increase m quantity of urine, fall of its specific gravity and corresponding decrease in percentage of albumen General condition appeared to improve with lessenmg of anasarca, breatlaless- ness, etc. On 3rd August, 1903, patient after a sadden a tack of dizziness and vomiting, with a few twitchmgs about the mouth, became unconscious, and died three mmutes after onset °^pLTmrXi Examination.--Flmd. in both pleural sacs and recent pleuritic adhesions in right. Passive congestion and ^dema of bases of lungs. Hypertrophy of left ventiicle of hear? Atheroma of aorta and coronary arteries. No pen- card al fluid. Passive congestion of spleen and hyer. Right k?5ney smaller than left. ^Both kidneys ^^--^ ^^^^^^^^ laritv of surface and adhesion of capsule. Cortex not greatly Sished, and kidneys, as a whole, mu^J^ ^^runk^^^^^ Some dulness of the meninges. Atheroma of ceiebial vessels. No excess fluid in ventficles. Brain othermse ap^^^^^^^^^^ normal. Eyes showed a usifoi^ T fjl h iJft eye behind the globe, and swelling of optic If ^P^^^^ ^^/^''J^^iXl the luemorrluige near the disc and a patch of old choioidal