CHRONIC BRIGHT'S DISEASE. 35 



from five to six pints of cows' milk daily. After the " cure " had beeo 

 continued in this manner for about four weeks, some of the patients 

 who, prior to the treatment, had been in the most wretched condition, 

 had got rid of then* dropsy, recovered an appearance of health, and re- 

 gained so much of their strength as to be able to resume their business 

 and even to perform hard labor. The albuminous character of the 

 urine, however, has disappeared in but one case ; in all the others it 

 persisted. I am unable to account for the eminently beneficial action 

 of milk upon Bright's disease. I propose to try whether it be possible 

 to obtain a physiological explanation of these results by a careful 

 analysis of the phenomena attending an exclusively milk diet, during 

 health as well as disease, especially by careful weighing of the body 

 and by taking accurate account of every thing taken into and ejected 

 from the system. 



If the above measures prove unsuccessful in averting the dropsy, or 

 in allaying that which already exists, the establishment of active dia- 

 phoresis is* strongly to be' recommended. No benefit, however, is to 

 be expected from the use of spiritus mindereri, the antimonials, and 

 other so-called diaphoretics. I have known patients in an advanced 

 stage of dropsy to rid themselves of it completely, in a few weeks, by 

 the daily use of a hot bath, of a temperature of 80 to 100 F., fol- 

 lowed by sweating for two hours in woollen blankets. The diaphoresis 

 was so great in one case, that as much as 800 cubic centimetres of the 

 sweat which had soaked through was collected in a wash-basin placed 

 undei the bed. All these patients were weighed before and after the 

 sweating, and the clinical journals show that, during the sweating, 

 they had lost two, three, and even four pounds in weight. However, 

 it cannot be denied that, in some cases, this procedure also failed, nor 

 that debilitated patients sometimes suffered so much from the process 

 that I was obliged to desist from it. Finally, I may state that, in one 

 instance, the abatement of the patient's dropsy was coincident with 

 the first appearance of uraemic convulsions. The profuse drain of 

 liquid from the skin naturally makes the blood more concentrated, and 

 this accounts for the absorption of the interstitial effusion. Since, 

 however, in parenchymatous nephritis, the effusion contains urea and 

 perhaps other salts, it is readily conceivable that an active abstraction of 

 liquid from the system would have the effect of overcharging the blood 

 with these materials, and might thus give rise to uraemia. However, 

 a closer investigation of the cases above mentioned has led to the con- 

 clusion that the supposed connection between diaphoretic treatment 

 and the uraemic symptoms is improbable. 



Whatever the theoretical objections against the employment of 

 diuretics may be, yet, in desperate cases, recourse should alwa}^s be 



