SYMPTOMS - ACUTE DEGENERATION OF THE KIDNEYS.
With the severe acute degeneration which follows the ingestion of large doses of arsenic, mercury, or one of the other inorganic poisons the urine is diminished in quantity, or suppressed; it contains albu min, casts, and blood; its specific gravity is unchanged. At first the general symptoms belonging to the poison predominate, but as these subside the patients continue to live and suffer more or less severely from the degeneration of the kidney. They become feeble, pass into the typhoid state, and often die.
The acute degeneration which accompanies the infectious diseases such as scarlatina, diphtheria, typhoid fever, pneumonia, etc., is for the most part of mild type and gives no symptoms except the pres ence of a little albumin and a few casts in the urine. It is of impor tance to recognize the frequency with which this affection of the kid ney occurs, the slight injury which it inflicts on the patient, and the completeness with which the kidney lesion disappears after the recovery from the primary disease. Much unnecessary anxiety is
often felt by physicians because in a case of pneumonia or some other infectious disease they find albumin and casts in the urine. There are fears not only of death from the primary disease, but of the sub segment development of " Bright's disease." If the albumin and casts are due to degeneration of the kidneys anxiety is needless. The course of the primary disease will not be changed. If the patients recover their kidneys return to their normal condition.
With yellow fever, with acute yellow atrophy of the liver, and oc casionally with the other infectious diseases the degeneration is of intense type, with death of a large part of the renal epithelium and exudation from the vessels. In such cases the urine is scanty or sup pressed. It contains albumin, casts, and blood. The patients are very ill, they may have convulsions, delirium, or stupor; they often die. But it is hard to tell how many of their symptoms are due to the complicating kidney lesion.