ALBU3IINU'RIA, or Buicurr's DISEASE, albumen in the urine, with dropsical ten dency, and organic change in the substance of the kidneys. Acute A. may commence with a chill followed by fever, dry skin, furred tongue, and rapid pulse; sometimes the countenance, or even the whole body, is swollen; urine greatly diminished, and dark red, as if bloody; dull pain about the loins, pallid skin, and thirst; loss of appetite, nausea, and vomiting. Rarely is there a complete suppression of urine, which is almost certainly fatal. Tested by heat and nitric acid, the urine shows so much albumen as to change almost into a mass of jelly. Under the microscope the sediment of the urine shows blood corpuscles, renal epithelium, and small fibrinous casts of the uriniferous tubes, containing entangled in them epithelial cells and blood globules. The causes of acute A. are exposure to cold, especially when the body is exhausted by fatigue, recent illness, or unsuitable diet; but excessive indulgence in alcoholic liquors is the most fruiful cause. Other diseases, in which the blood is in an altered condition, are sometimes preceded or followed by A., as acute rheumatism, typhus fever, erysipelas, and purpura; it may also follow scarlet fever, when it generally terminates favorably. No patient can be consid ered safe from A. so long as any trace of albumen can be found in the urine. The treat ment is easy; let the patient put on flannel, and stay in bed, if possible, in an evenly heated room, carefully guarding against exposure or cold currents of air; diet to be simple and digestible, and not over-plentiful; on or near recovery, preparations of iron are use ful to improve the blood and impart strength.
Chronic A. is sometimes thoroughly seated before suspected, and persons have died as was supposed from apoplexy, when the real cause was long-established albuminuria. But usually the symptoms are clear: loss of flesh, strength, and appetite, or, if appetite hold, flatulence and dyspeptic symptoms; the body becomes pallid, sallow, and looks waxy; the skin dry; swellings under the eyes, particularly in the morning, and the ankles oedematous at night; pain in the back, but generally not severe; there is irritability of the bladder, and a frequent desire to urinate ; urine sometimes copious, but often less than average, pale and of low specific gravity, from 1.004 to 1.012. On test
the quantity of albumen in the urine varies; sometimes it is large, (Men only a trace, or hardly that. As the disease goes on, dropsy of the abdomen is apt to occur and be the chief cause of suffering; anasarca is present, and all the cellular tissue is infiltrated with serum. There is a tendency to sleep which may lapse into coma, or alternate with epileptic convulsions. Bronchitis is apt to occur in severe form, or pneumonia to come insidiously and run rapidly to a fatal issue; rheumatism is not infrequent_ The variety of diseases which collect in a case of chronic A. is of course iu consequence of the con dition of the blood—the alterations in the blood being the diminished amount of globules, the hematine sometimes reaching only a third of its proper quantity, and the presence of urea. The duration of the disease varies: those exposed to the weather and who lack the comforts of life, often die suddenly, while in persons in condition to avoid exposure and fatigue it may last for years, leaving the victims a good degree of the enjoyments of life; but their situation is always precarious, and serious or fatal disease may at any moment come on from trifling causes. The main cause of chronic A. is intemperance in eating or drinking, but especially in the use of distilled and fermented liquors. Exposure to cold, wet, fatigue, want, and mental anxiety are occasionally causes, and there are cases where no cause can be traced. Where neither dropsy, nor other difficult complications demand attention, the treatment should be more in careful clothing, diet, and exercise than in medicines. Flannel next the skin is indispensable, and exposure to wet and cold must be guarded against; unusual exercise, physical or mental, is forbidden; diet should be moderate and nutritious, and above all taken with regularity; fermented liquors 'should be although if long habit render them necessary the patient should select that which best agrees with him. See BRIGHT'S DISEASE, ante.