536 DISEASES OP THE KIDNEYS. 



are ulcerated may, on standing, deposit considerable quantities of red 

 blood corpuscles. 



Exposed to the air, the urine rapidly assumes a brown tint and 

 smells strongly of ammonia. 



Percussion of the loins in the region of the kidneys causes pain, as 

 does external palpation by the flank. On rectal examination at this 

 period the ureters are found to be distended and hard, and they give 

 the impression of rigid or bosselated fibrous cords, sometimes as large 

 as a child's arm. The corresponding kidney, often both kidneys, are 

 enlarged, sometimes to double or treble their normal volume, and are 

 painful on pressure and fluctuating, at least in the region of the pelvis. 

 On vaginal examination the meatus urinarius is usually found to be in- 

 flamed, rough and turgid. 



In this condition the animals rapidly lose flesh, the appetite becomes 

 irregular, the general condition gradually gets worse, and they die as a 

 result of continued uro-septic fever or ur^emic troubles. 



The acute form takes a much more ra23id course, with fever, more 

 marked general disturbance, acceleration of pulse and breathing, the pas- 

 sage of turbid and sometimes purulent urine with a strong ammoniacal 

 smell. Pyo-nephrosis is the most frequent and characteristic end. Ordi- 

 nary chronic pyelo-nephritis may also occur in these cases, and the acute 

 course may be determined simply by accidental ascending infections. 



Diagnosis. During the early stages diagnosis is extremely difficult, 

 unless a careful examination of the urine be made. Afterwards it becomes 

 easy, the appearance of the urine and the indications furnished by 

 rectal exploration being perfectly characteristic. In very exceptional 

 cases there may be some doubt, as where the urine remains normal, in 

 spite of hydro-nephrosis, or where there is old-standing haematuria or 

 renal tuberculosis. In simple hsematuria the lesions are confined to the 

 bladder and ureters, the kidneys not being affected, and in renal tuber- 

 culosis the diagnosis can always be confirmed by the use of tuberculin. 



Prognosis. The prognosis is extremely grave, for the lesions pro- 

 duced are irreparable, and, moreover, local intervention is impossible. 



Treatment. There is no curative treatment. All that is possible is 

 palliative treatment with the object of facilitating the function of the 

 kidney and of disinfecting the urinary passages by administering anti- 

 septic substances which are excreted by the kidney. It is not possible, 

 however, to administer active drugs of this kind {e.g., combinations of 

 carbolic acid). As the kidney acts badly it soon ceases to eliminate such 

 substances, and the condition would not be improved, but aggravated. 



Benzoate of soda in doses of 2 to 2^ drachms per day dissolved in 

 diuretic liquids is the most useful drug, and sometimes holds the disease 

 in check for a sufficient time to allow of the animals, being fattened. 



