Traumatic  Albuminuria. — Transitory  albuminuria  follows  injury  to
the  brain,  apoplexy  e.g.;  after  injuries  crushing  the  kidneys  the  albu-
minuria and  casts  may  continue  for  a  long  time  w^ith  no  other  signs
of  nephritis.  This  may  explain  some  cases  of  benign  latent  contracted
kidneys  (Stern,  Curschmann).  Menge^-^  found  that  even  bimanual
palpation  of  the  kidney  in  physical  examination  w'ill  in  15  of  21  cases
cause  a  transitory  albuminuria  lasting  usually  from  one  to  twenty-
four  hours  at  the  most,  and  in  some  cases  a  slight  haematuria.  Any-
thing obstructing  renal  venous  flow,  as  in  movable  kidney  during  the
crises,  may  cause  albuminuria  and  cylindruria.
Febrile  Albuminuria. — During  any  acute  fever,  but  especially  pneu-
monia, typhoid,  malaria,  acute  articular  rheumatism,  grippe,  or  even
tonsillitis,  there  may  be  a  slight  albuminuria,  simultaneous  with  the
rise  in  temperature  and  disappearing  with  its  drop.  In  such  cases  the
cloudy  renal  epithelium,  the  faintest  grade  of  inflammation  (Leyden),
is  considered  the  anatomical  basis.  The  amount  is  usually  small,  but
sometimes  much.  Hyaline  and  epithelial  casts  are  sometimes  found,
but  no  other  formed  elements  indicating  inflammation.  In  general  it
is  only  a  matter  of  degree  which  separates  such  from  true  cases  of
nephritis.
Under  hamatogenous  albuminuria  is  included  a  very  confusing  group
of  non-febrile  cases  without  at  autopsy  renal  lesions,  except,  perhaps,
slight  parenchymatous  changes.  Among  this  group  are  purpura,
scurvy,  chronic  lead  or  mercury  poisoning,  lues,  leuksemia,  cachexias^
and  ansemias  in  which  the  albuminuria  is  always  slight  iand  occurs
only  when  these  conditions  are  severe,  cholaemia,  glycosaemia,  and
after  ether  and  chloroform  narcosis.
