516 MATERIA MEDIC A AND THERAPEUTICS. 



IV. NATURAL KECOVERY. 



So many of the disorders of the urine are but expressions 

 of derangement of the blood and of the great organic functions, 

 that it is hardly necessary to say that natural recovery con- 

 stantly occurs. Conversely, improvement in the condition of 

 the urine is an evidence of the spontaneous return of the 

 stomach, intestines, liver, heart, etc., to the normal state when 

 the causes of their disorder have been removed. 



The kidney possesses several provisions for natural re- 

 covery. It meets increased work by increased action ; compen- 

 satory hypertrophy of one kidney occurs if the other kidney 

 fail ; and a close vicarious relation exists between the kidney 

 and the skin and bowels. The practical therapeutist closely 

 follows these natural methods in arranging his treatment. 



V. THERAPEUTICS. 



A careful consideration of the four preceding sections specially 

 impresses two facts upon us. First, the rational treatment of 

 any case of renal or urinary disorders must be founded upon an 

 appreciation of the influences of other organs upon the kidneys ; 

 and, secondly, treatment may be as often directed to the kid- 

 neys for diseases of other organs as when they are themselves 

 at fault : diuretics will be as frequently employed to relieve 

 the heart as to stimulate the cells of the kidney. 



1. (a) Renal congestion from heart disease. This may be 

 taken as the type of renal disorder from diminished blood- 

 pressure, whatever its cause ; and such being the pathology of 

 the condition, the line of rational treatment is obvious. To re- 

 move the cause we must restore the normal relations of the 

 general circulation, that is, strengthen the heart, fill and 

 keep full the arteries, and empty the veins. How this is 

 to be done has been already discussed in chapter x., and 

 need not be repeated here. We are now able to estimate 

 the value of two sets of diuretic remedies which are success- 

 fully employed in such cases, namely, the cardio-vascular 

 diuretics, and the saline diuretics. Digitalis and Squill exactly 

 fulfil the indications just mentioned as regards the heart, the 

 arteries, and the veins. They increase the cardiac vigour and the 

 period of rest ; sustain the arterial tension at a moderate height ; 

 and empty the veins forwards by prolonging the diastole. At the 

 same time, partly by these effects and partly by their local action 

 on the renal vessels, they cause a true diuresis from the Malpig- 

 hian bodies, and increase the force of the circulation through the 

 renal veins. Ammonia, Alcohol, or Scoparium, may be com- 

 bined with these drugs ; and here it may be remarked, once for 



