538 DISEASES OF THE IClDNEYS. 



Symptoms. Suppurative nephritis is characterised hy fever, loss 

 of appetite, arrest of rumination, and frequent attempts to urinate. 

 These attempts are painful, are accompanied by groaning, and end in 

 the passage of an insignificant quantity of blood-stained and purulent 

 urine. 



Palpation, more especially palpation of the right flank, percussion 

 over the region of the loins, and examination of the kidneys through the 

 rectum are painful. Wasting is rapid. 



If the suppurative nephritis develops rapidly, and particularly if it be 

 accompanied by perinephritis, the patients refuse to rise and appear to 

 be suffering from paraplegia, although not really so, both sensation and 

 motor power persisting in a greater or less degree. Probably the condi- 

 tion is accompanied by reflex pain and irritation of the nerve-trunks of 

 the lumbo-pubic plexus. 



On the other hand, when suppurative nephritis tends to develop 

 slowly and assume a chronic form, lesions of pyo-nephrosis gradually 



Fig. 231. — Leaf lard around kidney of pig. 



develop, and are identical in appearance with those of hydro-nephrosis, 

 except that the ureters, the pelvis and the dilatations corresponding to 

 the lobules, are filled with pus. 



Diagnosis. The diagnosis is not very difficult. The urinary trouble 

 and the composition of the urine itself always arouse suspicion. The 

 diagnosis is confirmed by careful and methodical examination per rectum; 

 the inflammation of the fatty tissue surrounding the kidney can usually 

 be detected. 



Prognosis. The prognosis is extremely grave, and almost always 

 fatal, particularly in cases of diffuse nephritis. 



Treatment. No curative treatment can be absolutely relied on. 

 Treatment, if attempted, is limited to the methods suggested for pyelo- 

 nephritis. Mucilaginous, emollient, and diuretic drinks, and daily doses 

 of 2 to 3 drachms of benzoate of soda given in the drinking water, cause 

 some improvement. 



