DISEASES OF THE KIDNEYS. Y51 



contain pus cells in abundance; there is exudation into the 

 tubes and desquamation of the epithelium, constituting " epi- 

 thelial casts." Pyelitis, however, gives rise to the formation of 

 abscesses, which are principally confined to the cortex of the 

 kidney. These vary in size from a pin-head to a pigeon's egg, 

 or even larger. Abscesses are multiple and surrounded by con- 

 gested tissue, and sometimes by submucous haemorrhage ; this 

 was specially observable in the cow referred to. They are 

 easily seen through the capsule of the kidney as many yellowish 

 white spots. 



Interstitial nephritis consists of an inflammation of the inter- 

 lobular connective rissue, similar to cirrhosis of the liver, and 

 leads to contraction of the affected kidney. 



Treatment. — This must be according to the ordinary principles 

 of the treatment of inflammation. If the pulse be strong, a full 

 bleeding will be of much service, not only allaying the febrile 

 disturbance, but, by acting as an evacuant, removing much effete 

 material from the economy. The intestinal canal is to be freely 

 acted upon by cathartics, for direct experiment has shown that 

 the urea, &c. which accumulate in the blood are by this means 

 eliminated from the body, and the symptoms of ursemic poison- 

 ing delayed. For the horse, aloes; the ox, the sulphates of 

 magnesia or soda ; the dog, calomel and jalap, with enemas of 

 warm water, warm fomentations or poultices to the loins, 

 succeeded by mild mustard applications. 



If the suppression continue for several days, or if at any 

 time uraemic intoxication is apparent, it becomes necessary to 

 excite the secretion of urine, and the best and safest method 

 of doing this is by the application of digitalis to the skin in the 

 form of a decoction, repeatedly applied as a fomentation to 

 the loins, or as a poultice. It must, however, be discontinued 

 immediately after the kidneys have commenced to react. I can 

 speak with great confidence of this remedy if thus applied. 



If pain be a prominent symptom it must be relieved by 

 opium. 



It is scarcely necessary for me to say anything against the 

 application of cantharidine blisters, as the practitioner is aware 

 that they have a most irritating effect upon the urinary organs. 



As sequelae to nephritis, atrophy and degeneration of the 

 gland may result. If the inflammation be confined to one, it is 



