Hot baths and milk diet best meas ures. Diuretics useless. Though calo mel acts as such, stomatitis is difficult to avoid. Repenak (St. Petersburger med. Woch., Apr., '95).
Examination of six thousand speci mens at Denver, a mile above sea-level. Influence of high altitude: Acute ne phritis, though uncommon, is exception ally severe. Amyloid disease is less fre quent than text-books infer. Chronic parenchymatous nephritis is not influ enced. The chronic interstitial type of this disease is influenced favorably by the tonic, invigorating climate. Slight. transient albuminuria, due to high blood-pressure, is frequent. E. C. Hill (Jour. Amer. Med. Assoc., May 12, 1900).
Puncture of the kidney has recently been recommended.
Puncture of the kidney to relieve ten sion and cause cessation of albuminuria. Exploration of the kidney had been undertaken to discover if there were a co-existing morbid condition present. Good results followed and appeared in explicable. They were thought to be due to such factors as the division of a nerve. the moral effects of the operation, etc.
After several cases showed the same re sults, a different explanation became necessary. In three subsequent cases, one of scarlatinal nephritis, one of nephritis from exposure to damp and cold, and one of nephritis following influ enza, the albumin disappeared from the urine directly after surgical treatment; it was, therefore, believed that the albuminuria was due to a state of ten sion iu the kidney, which was relieved by the operation. In a proportion of cases of nephritis albuminuria disap pears; in others it is very persistent. It is in these that surgical exploration of the kidney is indicated. This is particu larly the case when the kidney compli cation is grave from the outset and there is more or less suppression of the urine, and when, after a limited time, the renal symptoms do not tend to disappear. The operation of exploration is so safe that it is justified in all severe renal disorders. "The kidney should be ex posed by a moderate incision from the loin, so as to enable the operator to feel the organ distinctly both in front and behind, aided, of course, by pressure exercised on the kidney by the hand of an assistant from the front of the ab domen. If. in conjunction with the pres
ence of albumin in the urine, the kidney is found in a state of tension, such as I have illustrated, three or four punctures may be made through the capsule in various directions; or, should the organ be found in a state of higher tension, then a limited incision into the cortex may be practiced. After one or other of these measures has been executed, the wound should be lightly packed with gauze or a drainage-tube substi tuted. In either case the incision should he dressed in such a manner as to pro vide for the free escape of either blood or urine or whatever products may be exuded." Reginald Harrison (Med. Weekly, Oct., '96; Med. Record, Nov. 7, '96).
Case of a woman suffering from a nephritis with profuse hmwaturia and alarming symptoms of uremia in which the disease was checked by a nephrot omy. Results given in 24 instances of intervention in uephritis, complicated by grave symptoms. In 9 cases of nephritis with haematuria there were 7 tomies with 2 deaths and 5 recoveries, 1 nephrectomy with recovery, 1 simple exploration with recovery. In 4 cases with subacute infectious nephritis these were submitted to nephrectomy and all recovered. In 8 cases of acute infectious nephritis there were 3 nephrectornies with recovery, and 5 nephrotomies with 2 deaths and 3 recoveries. As to the therapeutic results, in the first set the disappeared at the same time the urinary secretion and elimination of area were re-established. The pain abated in the nephralgias. The albumin disappeared in the cases of subacute ne phritis, and the fever and other symp toms in the severe infectious cases also disappeared. Pousson (Jour. Cut. and Genito.-Urin. Dis.; Ther. Gaz., Apr. 15, 1900).
Definition.—A chronic diffuse inflam mation of the kidneys, attended with epithelial degeneration, exudation from the blood-vessels, and permanent con nective-tissue changes in the renal stroma. This is one of two varieties of chronic Bright's disease, and is identical with Delafield's chronic productive (or diffuse) nephritis with exudation.