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April 23, 1910

Circulatory Changes in Chronic Nephritis

JAMA. 1910;LIV(17):1390. doi:10.1001/jama.1910.02550430042010

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To the Editor:  —In your editorial in The Journal, March 19, on "The Circulatory Changes in Chronic Nephritis," you review a purely mechanical explanation, and a theory that you call "the alternative hypothesis," attributing the cardiac and vascular phenomena of chronic nephritis to chemical excitation of the walls of the vessels by pathologic constituents of the blood.I suggest the propriety of considering another theory. I have formed a belief that the high blood pressure found in cases of defective kidney action is a compensatory phenomenon. Whenever any functional activity is required of an organ in the body, there is always a tendency to a rise of blood pressure, just as an engine puts on more steam to go up hill. When the kidneys are required to remove from the blood waste products circulating in it, there is a tendency to increased blood pressure. When the kidneys are permanently defective,

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