518 MATERIA MEDIC A AND THERAPEUTICS. 



" Large White Kidney." This is the form of kidney disease in 

 which there is the greatest or most constant danger of deficient 

 excretion, and of the consequences of the same throughout the 

 system. The indications for treatment are obvious. We must 

 relieve the diseased cells of as much work as can be safely dis- 

 pensed with by the blood and tissues. The rational methods of 

 relieving the renal epithelium are : (1) by reducing the food in 

 quality and richness ; and (2) by diverting the excrementitious 

 products to other channels. Hydragogue purgatives are es- 

 pecially valuable in this form of Blight's disease ; and the warm 

 air or vapour or water bath, warm drinks, and Jaborandi, will 

 successfully relieve the kidneys by perspiration. Renal stimu- 

 lants, such as the saline and specific diuretics, might, on the 

 other hand, exhaust the cells, already weakened by disease ; but 

 in certain cases they are highly useful even in this condi- 

 tion, for they may exert that amount of stimulation on the 

 renal cells which, on the principle of alteratives in general, will 

 lead to their restoration. If we believe that the tubules are 

 blocked by cellular and inflammatory products, we must clear 

 them by a system of flushing, or diuresis. For this purpose 

 Distilled Water is the best diuretic ; Digitalis and Squill are 

 also valuable, as producing but little local irritation, and tending 

 to prevent venous congestion. 



In this or in any other form of renal disease, urgent 

 symptoms of uraemia must be quickly relieved by venesection, 

 the administration of Chloroform, free purgation, and, if possible, 

 profuse diaphoresis. The anaemia generally demands Iron in 

 some form. 



4. Obstruction in the urinary passages. The most common 

 cause of this serious disease, namely, stricture of the urethra, 

 is fortunately accessible, and amenable to surgical treatment. 

 When the obstruction is above the bladder it is very rarely 

 bilateral, and the unaffected kidney takes on the double 

 function of the two. 



5. Disorders of the blood, liver, and digestion ; Gravel and 

 Calculus. The immediate treatment of these secondary disorders 

 of the liver, in their early stage, has been already suggested : 

 careful low dieting, and the occasional administration of chola- 

 gogue purgatives, stomachics, and antacids. If gravel or calculus 

 have actually formed, several other measures are still open to us, 

 whilst the same line of treatment is persevered in to prevent 

 further growth. We may attempt to dissolve the stone in 

 situ by the continuous admistration of Citrate of Potash, or 

 of acids, as the nature of the calculus demands, and relieve 

 pain, haemorrhage, mucous and purulent discharges on general 

 principles. 



