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all the impurities that would otherwise be retained in the system and cause trouble."

7. Kidney Trouble, Sheep-Sorrel Excellent for.—"Make a decoction of sheep sorrel, one ounce to pint of water; boil, strain and cool. Give wineglassful, three or four times a day. If necessary apply the spinal ice bag to kidneys." The sheep sorrel is a good kidney remedy, and the ice bag by continuous application will relieve the congestion.

[KIDNEY AND BLADDER 155]

MOVABLE KIDNEY. (Floating Kidney. Nephroptosis).—Causes.—This condition is usually acquired. It is more common in women than in men, possibly due to lacing and the relaxations of the muscles of the abdomen from pregnancy. It may come from wounds, lifting too heavy articles, emaciation.

Symptoms.—They are often absent. There may be pain or dragging sensation in the loins, or intercostal neuralgia; hysteria, nervousness, nervous dyspepsia and constipation are common. The kidney can be felt. A dull pain is caused by firm pressure. Sometimes there are attacks of severe abdominal pain, with chill, fever, nausea, vomiting and collapse. The kidney becomes large and tender. The urine shows a reddish deposit and sometimes there is blood and pus in the urine.

Treatment.—If the symptoms are not present, it is best for the patient not to know the true condition, as nervous troubles frequently follow a knowledge of its presence. If the symptoms are present, replace the kidney while the patient is lying down and retain it by a suitable belt. Also treat the nervous condition. If the symptoms are of the severe kind an operation may be needed to fasten the kidney in its proper condition. This is quite generally successful, and does away with much suffering and pain. The pain may be so severe at times as to require morphine. Sometimes the pain is due to uric acid or oxalates in the urine. For this regulate the diet.

Diet for Movable Kidney.—The diet should be such as to produce fat. Milk is excellent where it is well borne; if not well borne give easily digested meats, such as chicken, roast beef, broiled steak and lamb chop; fish of various kinds and vegetables, such as spinach, carrots, asparagus and cauliflower; of fats, butter, cream, and chocolate; for constipation, cider, buttermilk, grape-juice, fruits and honey.

ACUTE CONGESTION OR HYPEREMIA OF THE KIDNEYS.—This occurs at the beginning of acute nephritis; in acute infectious diseases, after taking turpentine, chlorate of potash, cantharides, carbolic acid, alcohol, etc.; after one kidney has been removed.

Kidney.—The kidney is enlarged, dark red, while the covering is very tight (tense). The urine is scanty, and there is increased specific gravity (normal is 1015 to 1020) and contains albumin and a few casts.

Treatment.—The cause should always be removed if possible. Rest in bed, and as a diet use only milk; if the congestion is bad, use dry cupping over the kidneys and inject large quantities of hot normal salt solution in the bowels. Hot fomentations of wormwood or smartweed are of benefit. If you can get the patient into a sweat the congestion will be somewhat relieved by it.

[156 MOTHERS' REMEDIES]

CHRONIC CONGESTION OF THE KIDNEYS. Causes.—Diseases of other organs and obstruction to the return of the circulation in the veins. Cirrhosis of the liver causes it. The kidney is enlarged dark red, the urine is diminished, with albumin and casts and sometimes blood.

Treatment.—Remove the cause if possible. Fluid diet, like milk, broths, etc. Dry cupping or sweating materials can be used. Rest in bed if possible. The bowels should be kept open, and the kidneys should rest.

BLOOD IN THE URINE. (Haematuria). Causes.—The congestion of the kidneys, pernicious malaria, etc., nephritis, tuberculosis, kidney stones. The urine looks smoky and dark, or bright red.

Treatment.—This depends upon the cause. The patient must rest in bed and the kidneys should not be stimulated. Cold applications to the loins. Hot applications would injure.

URAEMIC TOXAEMIA.—This means poison in the blood occurring in acute and chronic nephritis (inflammation of the kidneys). The cause is unknown. The disease is acute and chronic.

ACUTE URAEMIA. Symptoms.—The onset may be sudden or gradual. The headache is severe, usually on the back top of head (occipital) and extending to the neck; there is persistent vomiting with nausea and diarrhea attending it. This may be due to inflammation of the colon. Difficulty in breathing, which may be constant or comes in spells. This is worse at night, when it may resemble asthma; fever if persistent, is usually slight until just before death. General convulsions may occur. There may be some twitching of the muscles of the face and of other muscles. The convulsions may occur frequently. The patient becomes abnormally sleepy, before the attack, and remains so. One-sided paralysis may occur. Sudden temporary blindness occurs sometimes. There may be noisy delirium or suicidal mania. Coma (deep sleep) may develop either with or without convulsions or delirium, and is usually soon followed by them; sometimes by chronic uraemia or recovery.

CHRONIC URAEMIA.—This develops most often in cases of Arterio-sclerosis or chronic interstitial nephritis, (one kind of Bright's disease). The symptoms are less severe than those of acute uraemia, but similar, and of gradual onset, sometimes with symptoms of the acute attack. There is often constant headache and difficult breathing; the tongue is brown and dry, sometimes there is nausea, vomiting, diarrhea, sleeplessness, cramps of the legs and much itching may be present. It may last for years. Death may occur when the patient is in coma (deep sleep). There may have been mania, muscular twitchings or convulsions before death.

Treatment.—Found under "Chronic Interstitial Nephritis."

[KIDNEY AND BLADDER 157]

ACUTE BRIGHT'S DISEASE. (Acute Inflammation of the Kidneys. Acute Nephritis).—This occurs chiefly in young people and among grown men. Exciting causes are exposure to cold, wet, burns, extensive skin tears (lesions), scarlet fever, diphtheria, typhoid fever, measles and acute tuberculosis, poisons; and pregnancy is one cause when it occurs in women.

Symptoms.—After exposure or scarlet fever the onset may be sudden, sometimes with chills or chilliness, variable fever, pain in the loins, watery swelling of the face and extremities, then of other portions of the body like the abdomen, then general dropsy. Sometimes there is nausea, vomiting, headache, delirium, or very deep sleep. The urine is scanty, dark colored, of increased "specific gravity" and contains albumin, cells and casts. Anemia is marked. After some fever disease, the onset is gradual with anemia, swelling of the eyelids, face and extremities; scanty thickish urine containing casts, then headache, nausea, vomiting, little or no fever, dry skin. In these cases there may be gradual recovery, attack of uraemia, or they may end in chronic nephritis.

Diagnosis.—Examine the urine often in pregnancy, scarlet fever, etc., and especially when watery swelling is noticed.

Recovery.—The result in your children when it comes with scarlet fever is not so good. It may run into chronic nephritis. In adults when it is due to exposure the rule is recovery.

Treatment.—The patient must be kept in bed until there is complete recovery. He should be clothed in flannel.

Diet and Nursing.—This must be of milk, water or mineral water in large quantities; milk or buttermilk should be the main article of food. You can give gruels made of arrowroot or oatmeal, barley water, beef tea and chicken broth. But it is better to stick strictly to milk. As the patient gets better, bread and butter, lettuce, watercress, grapes, oranges, and other fruits may be given. The return to a meat diet should be gradual. The patient should drink freely of mineral waters, ordinary water or lemonade, these keep the kidneys flushed and wash out the "debris" from the tubes. One dram of cream of tartar in a pint of boiling water, add the juice of half a lemon and a little sugar; this when taken cold is a pleasant satisfactory diluting drink. Cream of tartar one dram, juice of lemon, sugar sufficient, water one pint, may be given whenever desired. There should be hot water baths daily or oftener; or you can produce sweating by placing hot water jars around the patient, and watch to see whether it is too weakening. It can also be done by introducing steam underneath the bedding, that is then lifted a little, so that the steam vapor can circulate about the patient. Be careful not to burn the patient with the hot steam. This, of course, is done through a hose attached to a steaming kettle. Also see treatment of dropsy under "scarlet fever."

Bowels, Attention to.—They should be moved every morning by a saline (salt) cathartic, if necessary, especially if the dropsy continues. This produces watery stool. Cream of tartar and epsom salts, equal parts, is good remedy; one-half teaspoonful every three hours for a child one year old until the bowels move freely; one-half to one ounce can be given to an adult.

[158 MOTHERS' REMEDIES]

CHRONIC BRIGHT'S DISEASE. (Chronic Parenchymatous Nephritis. Chronic Diffuse Desquamative or Tubal Nephritis. Chronic Diffuse Nephritis with Exudation). Causes.—Young adult life and most common in males. It may come from acute inflammation of the kidneys that was due to exposure, pregnancy, or scarlet fever, or follow excessive use of alcohol, etc. In children it usually follows acute inflammation of the kidneys or scarlet fever.

Condition.—The kidneys may be enlarged, with thin capsule, white surface, cortex thickened and yellowish, or whitish (large white kidney). The epithelium of the tubules is granular, or fatty or the tubules are distended and contain casts. Cells of the "Glomeruli" and their capsules are swollen. There is moderate increase of interstitial tissue. In other cases, the "small white kidney," the kidney is small and pale either at first or as a later stage of the large white kidney. The surface is pale, rough and granular; the capsule is thickened and partially adherent; the surface is thin with white and yellowish areas of fatty degenerations. The interstitial tissue is much increased; epithelial degeneration in the tubules extensive. There is also the large red kidney, and with any of these types the left heart may be enlarged and the arteries thickened.

Symptoms.—If it occurs after acute nephritis the symptoms of acute nephritis subside, but anemia and the changes in the urine persist. Usually there is a gradual onset with paleness and puffiness of the eyelids, ankles or hands in the morning. Later there is difficult breathing, increased watery swelling of the face, extremities and dependent portions of the body; worse in the morning. There is a pasty yellowish pallor, afterwards dropsy of the abdominal and chest cavities. The urine is diminished, high colored, specific gravity usually 1020 to 1025 with much albumin. Many casts which are named hyaline, granular, epithelial and fatty. The action of the heart is bad. There may be trouble with the stomach and bowels, constipated, etc. The digestion is poor and the patient frequently suffers with much gas. Recovery is rare after it has lasted one year.

Treatment. Diet.—Milk or buttermilk should be the main article of food. You can give gruels made of arrowroot or oatmeal, barley water, beef tea, and chicken broth, but it is better to keep strictly to milk. As the patient gets better, bread and butter, lettuce, watercress, grapes, oranges and other fruits may be given. The return to the meat diet should be gradual. The patient should drink freely of mineral water, ordinary water, or lemonade. These keep the kidneys flushed and wash out the "debris" from the tubes. One dram (teaspoonful) of cream of tartar in a pint of boiling water, add the juice of a half a lemon and a little sugar. This when taken cold is a pleasant, satisfactory drink. Medical treatment is not satisfactory. The only thing to do is to give medicines to meet the indications; fifteen to twenty grain doses of lactate of strontium. Diuretin also is used. Basham's mixture for anemia is of help in some cases. It can be bought at any drug store.

[KIDNEY AND BLADDER 159]

CHRONIC INTERSTITIAL NEPHRITIS. (Sclerosis or Cirrhosis of the Kidneys. Granular, Contracted or Gouty Kidney).—This is met with, (a) as a sequence of the large white kidneys forming the so-called pale granular or secondary contracted kidney; (b) as an independent primary affection; as a sequence of arterio-sclerosis.

Causes.—The primary form is chronic from the onset, and is a slow creeping degeneration of the kidney substance, and in many respects an anticipation of the gradual changes which take place in the organ in extreme old age. Families in which the arteries tend to degenerate early are more prone to this disease. Doctor Osler says: "Among the better classes in this country Bright's disease is very common and is caused more frequently by over-eating than by excesses in alcohol."

Arterio-Sclerotic Form.—This is the most common form in this country, and is secondary to arterio-sclerosis. The kidneys are not much, if at all, contracted; very hard, red and show patches of

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