HEIGHT'S DISEASE. 153 



medicine containing that drug, should be avoided on account of the extreme 

 susceptibility of people suffering from Bright's disease to its action. A very small 

 dose of either blue pill or grey powder would suffice to produce profuse salivation, 

 the occurrence of which would in all probability augment the severity of many of 

 the symptoms, and possibly imperil the patient's chances of recovery. Digitalis or 

 the resin of copaiba will be found useful in increasing the action of the kidneys and 

 diminishing the dropsy. The indications for their employment will be subsequently 

 jjivni. ( .sV<{ DIGITALIS and COPAIBA in the " Materia Medica.") When the fever has 

 abated and the dropsy is yielding, the more active measures may be discontinued, 

 or pursued less energetically; but the efforts to restore or maintain the action of the 

 skin should be persevered in. When convalescence is fairly established and not 

 till then iron may be given with advantage. It is best to begin with small doses, 

 and if it agrees tp gradually increase them. A table-spoonful, or even half a table- 

 spoonful, of the mixture (Pr. 1) every four hours will be enough to commence with, 

 the full dose being worked up to in time. The action of the iron is to diminish the 

 quantity of albumen in the urine. w 



When the patient has recovered from his attack, unusual care will have to be 

 taken to guard against a relapse, to which there is always a tendency for a consider- 

 able time. The slightest exposure to cold or wet is often sufficient to cause 

 the re-appearance of the albumen in the urine, with a repetition of all the old 

 symptoms. When the patient is strong enough to be moved, and the urine has 

 completely regained its normal character, a change of air to a warm sheltered 

 locality is likely to prove highly beneficial, and to hasten the restoration of the 

 impoverished blood. 



Sometimes acute Bright's disease, instead of taking its departure and leaving the 

 patient to recover from the effects of the attack, assumes a chronic form. In the 

 great majority of cases, however, chronic Bright's disease is not a sequel of an acute 

 attack. On the contrary, it begins slowly, insidiously, and almost imperceptibly. 

 In very many cases it is not detected, its existence is not even suspected, until it has 

 existed for months, and perhaps for years. At length the patient is awakened to a 

 sense of his condition by the gradual failure of his strength, the increasing pallor 

 and sallowness of his complexion, and his disinclination or even inability for 

 exertion. Perhaps his suspicions are awakened by a little puffiness under the eyes, 

 a slight swelling of the ankles at night, or by unusual frequency of passing water. 

 Sometimes the disease creeps on stealthily in the wake of some pre-existing disorder, 

 such as consumption, gout, constitutional syphilis, or chronic alcoholism. It may 

 remain long concealed, and then suddenly reveal itself in the guise of an acute 

 attack after exposure to cold or a fit of intoxication. 



As we have already said, there are several different varieties of kidney disease 

 included under the general term of Bright's, and it is only right we should state 

 that when we speak of the symptoms of chronic Bright's disease we are speaking 

 only in general terms, and that our statements, though in the main correct, may be 

 found to be inapplicable to certain conditions. For example, as a rule, the urine con- 

 tains albumen, but occasionally, even in confirmed and fatally-ending cases, only the 

 minutest traces may be detected. Again, in the large majority of cases there is 



