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January 20, 1900


JAMA. 1900;XXXIV(3):178. doi:10.1001/jama.1900.02460030052017

It is a fair question whether renal albuminuria can ever be considered a normal manifestation. If the answer be in the negative, the condition must be considered an indication of disease, however slight and transsient. Disease is best defined as a deviation from the normal, in function or structure, or both. In fact, there can be no abnormity in function without alteration in structure, although this may be beyond our means of recognition. Unless, therefore, albuminuria be a normal phenomenon, it can scarcely be designated "physiologic." It is fair to assume that albuminuria occurs essentially as the result of disease in the epithelium of the uriniferous tubules, and this may be due, among other things, to alterations in the vascular pressure in the kidneys, sometimes increase, sometimes diminution, and at different times fluctuations between the two. These alterations must, in the absence of gross organic disease, eventually be referred to

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