10 DISEASES OF THE KIDNEY. 



greatest amount of confidence. Next to it, secale cornutum, or ergotine, 

 may be given, but the doses must be large. The only effect to be ex- 

 pected from the preparations of iron is the beneficial action which 

 they exert upon the deterioration of the blood. 



CHAPTER III. 

 ACUTE HEIGHT'S DISEASE. 



ETIOLOGY. The name Bright's disease is generally applied to two 

 forms of inflammation of the kidney. The first, which is the subject 

 of the present chapter, is closely allied to croup of the larynx and air- 

 vesicles, not only in its anatomical lesions consisting of a coagulating 

 exudation, containing epithelial cells, and often extravasated blood- 

 cells, and which fills up and occludes the urinary tubules but in its 

 course, which is always acute, like that of the other croupous diseases 

 above mentioned, and nearly always terminates either in recovery or 

 death within a few days. It is rare for the disease to pass into the 

 second form of Bright's disease, which we shall describe in the next 

 chapter, under the name of " parenchymatous nephritis." This latter 

 circumstance, indeed, seems to me to indicate that it is both right and 

 practical to regard acute and chronic Bright's disease as independent 

 and distinct affections. I attach little value to the term " croupous 

 nephritis," applied to acute Bright's disease, in the previous editions 

 of this work, as I must acknowledge that it is a matter of doubt 

 whether the exudation which fills up and obstructs the uriniferous 

 tubules consists of fibrin like the exudation of croupous laryngitis and 

 croupous pneumonia, and as it cannot be denied that the epithelium of 

 the uriniferous tubules takes a more active part in the nutritive disor- 

 ders attending acute Bright's disease than is taken by the epithelial 

 cells of the larynx and air-vesicles in croupous laryngitis and croupous 

 pneumonia. 



1. Acute Bright's disease is a frequent complication of scarlatina. 

 There is a prevalent notion among the laity that a child who dies of 

 dropsy, after scarlet fever, "has not been well taken care of;" and 

 many an unhappy mother, who has lost her child from this cause, re- 

 proaches herself for years for having changed its linen too soon, or im- 

 prudently opened a door, and thus brought about her child's death. It 

 is possible that chilling of the skin during scarlet fever may sometimes 

 favor the occurrence of croupous inflammation, and may even actually 

 produce it, but it is certainly not the case in the majority of instances. 

 Besides the disturbance of the skin which it occasions, scarlatinous 

 inrus constantly induces disorders of the fauces and kidnevs. In mosl 



