A Case of Phthisis

1872 Boston Medical and Surgical Journal  
which can bo considered to indicate to the ' slightest degree any renal disorder. , The connection between the retinitis and tho organic changes in the kidneys is doubtless duo to the operation of some one causo which produces them both. In other words, tho degeneration of tho retina and the degeneration of the kidneys are the common expression of somo bodily condition which we are as yet unable to understand. When we consider the extremely delicate tissues of the former, and the comparatively
more » ... the comparatively stable structures of the latter, we cannot bo surprised that the retina should present morbid changes before we can obtain any evidence of implication of the kidneys-the only wonder being that this mode of development should not be more common than the recorded observations would lead us to infer. I am inclined to believe that a careful and systematic examination of tho intraocular structures with the ophthalmoscope in every case in which nervous symptoms are complained of-these examinations being frequently repeated, and the patient watched for a length of time-will ultimately establish the fact that in a large proportion of cases Bright's disease will first manifest itself by the characteristic changes which it produces in the retina, and that these retinal appearances will be present for a length of time before any abnormal ingredients can be detected in tho urine.
doi:10.1056/nejm187203280091302 fatcat:usclmwund5axndoyfrmyxhj3t4