SYMPTOMS.
Acute congestion may occur in kidneys previously normal, or in those already diseased.
The urine is diminished in quantity or suppressed; its specific gravity is unchanged; it contains blood, albumin, and casts.
(1) Congestion Caused by the Inyestion of Poisons.
Cantharides given internally, or used in blisters or ointment, is rather a frequent cause of acute congestion of both the kidneys and the bladder.
The urine is diminished in quantity; it is passed frequently, iu small quantities, with much pain; or it is retained. It contains albu min, a few casts, and blood. Sometimes large, jelly-like coagula are formed in the bladder.
The patients may have a moderate rise of temperature, pain in the back, abdominal pain, nausea and vomiting, diarrhoea, more or less prostration, delirium, and stupor. The severity of the symptoms depends on the quantity of the drug absorbed. In the bad cases of poisoning the condition of the kidneys is not that of hypermmia, but of actual inflammation.
When there is only hyperpernia the patients are sick for a few days, and the urine soon returns to its natural condition. Turpentine pro duces symptoms like those of cautharides.
the poison has been taken into the stomach, that organ is to be emptied and washed out. Warm baths, or a hot pack, and the use of small doses of opium are of service. Camphor' in doses of from 2 to 5 grains every three hours has been recommended in cantharides poisoning.
(2) Congestion Following the Removal of One Kidney.
The urine is scanty or suppressed, and contains albumin and casts. The patients are in a condition of prostration which is very alarming. They may remain in this condition for a few days and then recover, the urine returning after a time to its natural condition; or they become more and more feeble, pass into the typhoid con dition with mild delirium, and die.
Treatment.—The patients are to be kept perfectly quiet in bed, on a fluid diet. They should have one or two long hot packs every day so as to produce congestion of the skin and profuse perspiration.
(3) Congestion after Injuries, or Surgical Operations.
It is well known that any operation on the bladder or urethra, even the passage of a catheter, may be followed by suppression of urine, great prostration, and death within forty-eight hoUrs, and that after death no lesion is found except congestion of the kidneys. These cases are not to be confounded with the cases of septic infec tion and fever, which may also follow operations on the urethra and bladder.
It is not so well known that surgical operations on any part of the body are occasionally followed by suppression of urine, congestion of the kidneys, and death. We do not know that death in all these cases is caused by the congestion of the kidneys, but there can be no question that congestion of the kidneys is produced in this way.
Treatment.—No satisfactory treatment has vet been found for these patients; in fact, the very short time which intervenes between the operation and death hardly gives time for treatment.
(4) Acute Congestion after Over-Exertion.
Prolonged marches, violent gymnastic exercises, contests of walk ing and running prolonged over several days may be followed by the excretion of such a quantity of albumin and casts in the urine as to indicate a temporary congestion. I do not know of any post-mortem observations which corroborate this belief. There are no other symptoms besides the changes in the urine, and these disappear after a few days' rest.