Study of several hundred of cases of nephritis has shown that chronic ne phritis is not an incurable disease; re covery occurs in rare cases. It may exist for years without causing ap parent constitutional disturbance. The average duration in three hundred and thirty-two cases of chronic nephritis was nineteen months. Acute nephritis is less C0111111011 than has been sup posed; many eases that were formerly so classified are found to represent exacerbations of chronic nephritis. R. C. Cabot and F. W. White (Boston Med. and Surg. Jour., Aug. 10, '99).
Treatment.—This is conducted much as in acute nephritis. The urtemia and dropsy are treated symptomatically. The diet is of great moment, skimmed milk and buttermilk being depended on as much as possible when the dropsy is marked. When the dropsy is slight, more solid food, white meats, vegetables, and fruits, and an out-door life should be recommended. Prolonged, sudden exercise and severe exercise should be prohibited.
Importance of combating the tendency to amemia, the prognosis remaining good as long as this condition is averted. Stephen Mackenzie (Brit. Med. Jour., Feb. 20, '93).
Woolens should be worn next to the skin, and residence in a warm, dry cli mate may aid in extending life.
Nitroglycerin may be needed in cases with contracted and tense arteries, with a tendency to urfnmic twitchings, and digitalis may be useful in cardiac weak ness. Basham's mixture for the anaemia and unirritating diuretics will prove of value, and strontium lactate, in doses of from 15 to 20 grains, three or four times daily, may be tried in some cases.
Three cases of nephritis treated by lactate of strontium; an excellent diu retic in the acute forms and in acute attacks occurring in the course of the chronic form. Da Costa (Med. News, Apr. 21, '94).
Child, 5 years of age, who suffered from chronic Bright's disease and whose urine contained large quantities of serum-albumin and globulin. Lactate of strontium increased the quantity of urine and solids excreted and the pa tient rapidly recovered. Gillespie (Med. Chronicle, Sept., '94).
Lactate of strontium is beneficial, in a large number of cases, when sclerosis has not begun. It produces nausea in powder, but not when dissolved in water, 1 to 6 parts, three or four tablespoonfuls being given daily. 'lied (Med. and
Surg. Reporter, Jan. 26, '95).
Lactate of strontium tried in 10 cases of Bright's disease: 3 of acute parenchy matous, 6 mixed, and 1 interstitial. The favorable action of salts of strontium on the kidneys is not due to their dimin ishing putrefaction in the intestines. Direct experiments with bacteria show ing that the antiseptic properties of lac tate of strontium are insignificant, and that the presence of ethero-sulphuric acids in the urine is not influenced by the use of the drug. Bronowski (Medy cyna, No. 1, '96).
There is a great deal of mischief done by iron in Bright's disease. It may be laid down as a rule to which there is almost no exception that the iron is not indicated, and should not be prescribed, in cases of acute Bright's disease. Ou the other hand, after the acute symptoms have passed away and convalescence sets in, iron is very useful. A second class of cases in which iron is contra-indicated is chronic interstitial nephritis, in which it is more promptly and dangerously harm ful than in any other form of Bright's disease. The form. of Bright's disease in which iron is best borne is chronic paren chymatous nephritis. The proper dose should be determined by an examination of the stools, and, if these are decidedly blackened, too much is being given. Basham's mixture is no more diuretic than the bulk of water which constitutes its menstruum. James Tyson (Journal Amer. Med. Assoc., July 23, '98).
Methylene has also given satisfaction in some cases.
Methylene-blue is recommended in chronic nephritis. Dose, from 3 to 5 grains a day. Man of 58 years, suffering from chronic Bright's disease with renal congestion and albuminuria, was ad mitted to the hospital. On the 25th of February he was passing six grammes of albumin a day. He was given a modified milk diet and treatment with alkalies and tannin. Shortly afterward he was placed upon methylene-blue in dose of 4 grains a day. On the 3d of March he was passing four grammes of albumin; four days later he was passing two grammes; and on March 10th he was passing 20 grains. Lemoine (Jour. des Praticiens, May 22, '97).
Non-exudative Chronic Nephritis.