152 



THE TREATMENT OF DISEASES. 



passed in small quantities, and when the doctor examines it he finds that it contains 

 a great deal of albumen ; there may even be some blood. 



The attack may last for a period varying from a few days to some weeks. One 

 of the earliest signs of a favourable termination is an increase in the amount of 

 urine to three or four pints or more in the course of the twenty-four hours. At the 

 same time the skin becomes moister, and the dropsy gradually decreases. An attack 

 of Blight's disease, such as we have described, is a very serious matter, particularly 

 from its tendency to give rise to lung complications; but nevertheless, in the majority 

 of cases, a favourable termination may be expected. 



In every case of acute Bright's disease the doctor should be sent for without delay. 

 As, however, medical assistance is not always at hand, we will indicate the general 

 course of treatment to be adopted. The patient should be strictly confined to bed, 

 should be wrapped up in flannels, and made to lie between the blankets. A large 

 hot linseed-meal poultice should be applied to the loins, and changed every three 

 hours, or oftener if necessary. A hot bath should be given every evening or every 

 alternate evening, to promote the action of the skin; or, when appliances are at 

 hand, a hot-air bath may be-advantageously substituted. A " blanket bath " often 

 proves useful. A large thick blanket is wrung as dry as possible out of boiling 

 water, and as soon as it is cool enough to be borne it should be wrapped round the 

 patient, who is then to be covered with bed-clothes, which are to be heaped up over 

 him. In twenty minutes or half an hour the wet blanket should be removed, and 

 the skin quickly dried with a warm soft towel. Respecting the general manage- 

 ment of the patient there is little more to be said. The room should be well ventilated, 

 and should be kept at a moderate and equable temperature. At the commencement 

 of the attack there is little desire for food, but considerable thirst two natural 

 indications by which we may be safely guided. The diet should be composed chiefly 

 of light farinaceous food, and milk should be administered freely. The action of the 

 kidneys may be materially promoted by getting the patient to drink plenty of 

 water or any simple fluid, care being taken, however, not to allow him to over- 

 distend the stomach by taking too much at a time. 



Next, as to the medicinal treatment. If the complaint can be caught quite at 

 its commencement, aconite is the best remedy. It should be administered in the 

 form of the aconite mixture (Pr. 38) we have so frequently had occasion to use. 

 The dose is a tea-spoonful every ten minutes for the first hour, and subsequently 

 hourly. This treatment should be commenced immediately the nature of the 

 complaint is suspected, and without losing time by waiting for the arrival of the 

 doctor. Even if you are wrong in supposing that it is Bright's disease, no harm 

 will have been done. You are nearly always safe in giving aconite when any one is 

 feverish. 



Respecting the subsequent treatment we have little to add to what we have 

 already said when speaking of the treatment of dropsy. The bowels should be freely 

 opened by compound jalap and bitartrate of potash powder (Pr. 98), the dose of 

 which must be regulated by the age of the patient. For example, a boy of four 

 would require only a quarter of the adult dose. Care should be taken to guard 

 against excessive purging, as it is apt to prove very weakening. Mercury, or any 



