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.
