DISEASES OF THE URINARY ORGANS 113 



phates). The bladder is provided with a double set of muscles 

 (sphincter vesicse, detrusor urinse) ; the motor centre for the bladder 

 is in the lumbar cord. 



Therapeutic Methods. — Different methods can be used in the 

 treatment of diseases of the kidneys. 



1. Acting upon the secreting epithelium may be regarded as the 

 direct method. It consists in the stimulation of the depressed 

 urinary secretion and is essentially medical. See the diuretics 

 (caffeine, theobromine, theocine, diuretin, agurin). 



2. Acting upon the renal circulation (blood-vessels, blood, 

 blood-pressure, nervous system) has also the effect, but indirectly, 

 of increasing the secretion or filtration of urine (digitalis, water, 

 milk, alkalies, reflex cutaneous irritation). 



3. The derivative method relieves the diseased kidneys by 

 increasing the secretions of the intestinal (cathartics), cutaneous 

 (diaphoretics, baths) and saUvary (arecoline, pilocarpine) glands. 



4. A disinfectant action can probably be exerted upon the kid- 

 neys and also upon the bladder by the use of salicylic acid, tannic 

 acid, uva ursi, etc. This is denied by some. 



5. Abnormality in reaction can be removed by the administra- 

 tion of alkalies and acids. 



6. Rest of the diseased renal tissues is obtained by bodily quiet 

 and a certain diet (food poor in albumin and producing httle urea; 

 milk especially). 



7. The operative method includes the removal of cystic cal- 

 culi and local treatment of the bladder; also the excision of dis- 

 eased kidneys. 



DIURETICS 



Synonyms: Hydragogues, litholytics, lithothryptics. 



Actions. — The normal secretion of urine in the kidneys (phys- 

 iological diuresis) occurs as a result of the cooperation of various 

 factors, of which the most important are the secretory activity of 

 the renal epithelium, the blood-pressure, the blood content of the 

 glomeruU and the diffusion activity of the renal parenchyma. 



