BRIGHT’S DISEASE OF THE KIDNEYS

GRANULAR OF FATTY DEGENERATION OF THE KIDNEYS

This is somewhat rare disease, and in the acute from, the symptoms resemble those of acute inflammation of the kidneys, but it is distinguished from the latter affection by the urine containing albumen, or a substance similar to the white of an egg; and often by the occurrence within a few of days of symptoms of acute dropsy. To detect albumen in the urine, if it is cloudy or muddy, strain it, then heat it in a silver spoon, earthen dish, or tin cup, to the boiling point, then if there is no change in its appearence, drop in a few drops of vinegar and heat it again. If the urine contains albumen when it is thus treated, there will soon appear white curdy flakes, if the quantity is considerable, but if it is small, there will merely be a whitish cloudiness.

The chroine form of this disease is much more common than the acute. The symptoms are often very obscure at their commencement. A growing weakness, some derangement of the digestive organs, an occasional tendency to frequent passages of urine. With diminution of the quantity discharged, or some irregularity in its appearance, with perhaps obscure pains in the small of the back, are usually among the first symptoms noticed; and even these may escape notice, or least may not caused the patient to a physician until dropiscal swellings appear, which commence in the face and extend over the whole body. There may be some tenderness over the region of the kidneys on strong pressure, and the quantity of urine discharged is found to be less then during health, and its density or weight is also diminished, and it usually contains more or less albumen. As the discharge progresses the blood gradually loses its coloring matter, and the patient become very pale. The albumen although generally present in the urine, is no always constantly so, but its specific gravity, or weight, in equal quantity compared with healthy urine, gradually diminishes, and the countenance of the patient, from the loss of the red globules of the blood, often acquires, before death, a waxen yellowish white deathlike hue. Dropsy generally attends this disease, but it is not always present; not is the presence of albumen in the urine always positive evidence of the existence of this affection; but when the urine is scanty and contains more or less albumen, although perhaps free from it at times, and when at the same time the specific gravity or weight of the urine is steadily diminishing until it is considerable less than during health, you may be reasonably sure that the patient is suffering from this disease; and he occurrence of dropsy and pale and bloodless countenance, will strengthen this opining. Diseases of the heart, especially enlargement of the heart, and also disease of the liver, are frequent complications of this affection, and patients suffering from this disease are very subject to inflammatory diseases.

Treatment

The treatment in both the acute and chronic form of the disease is very similar to that recommended inflammation of the kidneys. In acute cases Aconite, Cannabis and Cantharis may be given as there directed. Belladonna will not be required. In chronic cases the last two remedies will often be useful also Lycopodium, Calcarea carb, and especially spirits of turpentine. If symptoms of dropsy occur in either case give Apis Mel. Once in four hours, and if within a few days there is no improvement, alternate it with Arsenicum at intervals of four hours.