72 



During recovery a course of bitter tonics (nux vomica 1 scruple, 

 ground gentian root 4 drams) should be given. The patient should 

 also be guarded against cold, wet, and any active exertion for some 

 time after all active symptoms have subsided. 



CHRONIC INFLAMMATION OF THE KIDNEYS. 



Chronic inflammation of the kidneys is more commonl}^ associated 

 with albumen and casts in the urine than the acute form, and in some 

 instances these conditions of the urine may be the only jjrominent 

 symptoms of the disease. Though it may supervene on blows, injuries, 

 and exposures, it is much more commonly connected with faulty con- 

 ditions of the sj'Stem — as indigestion, heart disease, lung or liver dis- 

 ease, imperfect blood formation or assimilation. In short, it is rather 

 the attendant on a constitutional infirmity than on a simple local 

 injury. 



It may be associated with various forms of diseased kidney, as 

 shrinkage (atrophy), increase (hypertrophy), softening, red congestion, 

 white enlargement, etc., so that it forms a group of diseases rather 

 than a disease by itself. 



The symptoms may include stiffness, weakness, and increased sensi- 

 bility of the loins, and modified secretion of urine (increase or sup- 

 pression), or the flow may be natural. Usually it contains albumen, 

 the amount furnishing a fair criterion of the gravity of the affection, 

 and microscopic casts, also most abundant in bad cases. Droj)sy, 

 manifested in swelled legs, is a significant symptom, and if the effusion 

 takes place along the lower line of the body, or in chest or abdomen, 

 the significance is increased. A scurfy, unthrifty skin, lack-luster 

 hair, inability to sustain severe or coutinued exertion, i)oor or irregular 

 appetite, loss of fat and flesh, softness of the muscles, and pallor of 

 the eyes and nose are equally suggestive. So are skin eruptions of 

 various kinds. Anyone or more of these symptoms would warrant an 

 examination of the urine for albumen and casts, the finding of Avhicli 

 signifies renal inflammation. 



TreatTnent of these cases is not always satisfactory^, as the cause is 

 liable to be maintained in the disorders of important organs elsewhere. 

 If any such coincident disease of another organ or function can be 

 detected, that should be treated first or simultaneously with this affec- 

 tion of the kidneys. In all cases the building up of the general health 

 is important. Hence a course of tonics may be given (phosphate of 

 iron, 2 drams; nux vomica, 20 grains; powdered gentian root, 4 drams, 

 daily), or 60 drops of sulphuric acid or nitro-muriatic acid may be 

 given daily in the drinking water. If there is any elevated tempera- 

 ture of the body and tenderness of the loins, fomentations may be 

 applied, followed by a mustard pulp, as for acute inflammation, and 

 even in the absence of these indications the mustard may be resorted 

 to with advantage at intervals of a few days. In suppression of urine, 



