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February 24, 1923


JAMA. 1923;80(8):554-555. doi:10.1001/jama.1923.02640350036017

Most physicians think of chronic nephritis as essentially a kidney disease, which, in the narrower sense, it is. The prominent symptoms are those immediately attributable to the profound disturbance in the renal functions. The changes in the composition and character of the urine cannot fail to direct attention specifically and emphatically to the kidneys. Structural elements of various sorts are usually present in the secretion of these organs, and the normal constituents of the urine are likely to be diminished in quantity. Retention is a common manifestation. What the etiologic factors may be has been the subject of considerable divergence of opinion. The greatest emphasis has probably been placed on toxic agents, such as poisons which bring about a slow chronic intoxication, or products of endogenous origin that may work quite as insidiously and dangerously. Toxins derived from bacterial sources in the organism have been accused, and the severe reactions