34: DISEASES OF THE KIDNEY. 



with aloes and in the form of a pill. The elimination of tannic acid 

 through the urine in the form of gallic acid and pyrogallic acid, 

 to which we have alluded elsewhere, warrants this treatment from 

 a theoretical point of view. Frerichs himself admits that, although 

 he has observed a diminution in the quantity of albumen excreted, 

 yet, in chronic cases, he has but seldom seen a complete disappear- 

 ance of it. My own experience does not speak at all in favor of 

 tannic acid. 



Bad as we have represented the prognosis of parenchymatous ne- 

 phritis to be, we have often succeeded quite brilliantly in palliative 

 treatment, and, in fulfilling the symptomatic indications, the therapeu- 

 tics of Bright's disease are by no means to be regarded as powerless. 

 We have recognized the loss of albumen from the blood as the imme- 

 diate cause of most of the symptoms of the disease, and hence our 

 most important task by far is to cover the loss of albumen by a diet 

 rich in protein substances, and by appropriate medication. Soft-boiled 

 eggs, milk, strong meat-broths, and roast-beef, in as large quantity as 

 the patient is able to digest, are probably the best preventives of the 

 dropsy ; and, while patients in comfortable circumstances often with- 

 stand the loss of albumen with impunity for years, the poor, on the 

 other hand, succumb to it far more speedily, because the former have 

 better means than the latter to supply the daily losses which they 

 suffer. Besides this, a moderate amount of beer or good wine should 

 be prescribed, as by the use of these articles the waste of tissue is 

 retarded and the nutrition promoted. Quinine and iron are the most 

 suitable medicines. The former was thrown overboard by many phy- 

 sicians during the time of a generally prevailing nihilism in therapeu- 

 tics, and its supposed tonic action upon the fibres has been much de- 

 rided. But, in these days of reaction against such nihilism, tonics, and 

 especially the preparations of quinia, have once more come into repute, 

 and, indeed, it would seem that they do exert a beneficial action upon 

 the state of nutrition by diminishing the consumption of material. 

 Preparations of iron are equally appropriate, since their effect upon the 

 formation of blood is most decided, and it is not the albumen of the 

 blood alone but also the red blood-corpuscles which are reduced in 

 quantity in this disease. Neglect of such directions as the above, a 

 blind groping in search of a specific remedy, and a vague, planless ex- 

 hibition of diuretics after the dropsy has set in, are merely so many 

 tokens of incapacity on the part of the physician. In a series of cases, 

 which have been described by Dr. Schmidt, in his inaugural thesis, I 

 have obtained most brilliant results where all other treatment had 

 failed, by putting the patients upon an exclusive diet of milk. The 

 patients did not take a grain of any medicine whatever, but drank 



